Healthcare Provider Details

I. General information

NPI: 1265528335
Provider Name (Legal Business Name): GYNECOLOGIC ONCOLOGISTS OF NORTHEASTERN OHIO, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/05/2006
Last Update Date: 02/27/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

224 W EXCHANGE ST SUITE #140
AKRON OH
44302-1704
US

IV. Provider business mailing address

224 W EXCHANGE ST SUITE 140
AKRON OH
44302-1704
US

V. Phone/Fax

Practice location:
  • Phone: 330-344-6041
  • Fax: 330-344-6449
Mailing address:
  • Phone: 330-344-6656
  • Fax: 330-344-6449

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VX0201X
TaxonomyGynecologic Oncology Physician
License Number
License Number State

VIII. Authorized Official

Name: MRS. DEBORAH J. CUGINI
Title or Position: ADMINISTRATOR
Credential: CMM
Phone: 330-344-2072