Healthcare Provider Details

I. General information

NPI: 1740528223
Provider Name (Legal Business Name): TERRI LYNN VACCARELLI PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/18/2013
Last Update Date: 09/17/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

137 S MAIN ST STE 100
AKRON OH
44308-1416
US

IV. Provider business mailing address

137 S MAIN ST STE 100
AKRON OH
44308-1416
US

V. Phone/Fax

Practice location:
  • Phone: 330-918-6000
  • Fax: 330-918-6851
Mailing address:
  • Phone: 330-918-6000
  • Fax: 330-918-6851

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number50.003727RX
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberMA055989
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: