Healthcare Provider Details

I. General information

NPI: 1457315111
Provider Name (Legal Business Name): EMILY DIBARTOLOMEO PA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/12/2006
Last Update Date: 06/17/2021
Certification Date: 06/17/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3925 EMBASSY PKWY STE 200
AKRON OH
44333-8400
US

IV. Provider business mailing address

3925 EMBASSY PKWY STE 200
AKRON OH
44333-8400
US

V. Phone/Fax

Practice location:
  • Phone: 330-668-4055
  • Fax: 330-668-4077
Mailing address:
  • Phone: 330-668-4040
  • Fax: 330-668-4077

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number50.002121RX
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: