Healthcare Provider Details

I. General information

NPI: 1306220363
Provider Name (Legal Business Name): MARCY GONCZY CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/18/2015
Last Update Date: 06/04/2026
Certification Date: 06/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 5TH ST SE
BARBERTON OH
44203-4259
US

IV. Provider business mailing address

101 5TH ST SE
BARBERTON OH
44203-4259
US

V. Phone/Fax

Practice location:
  • Phone: 330-745-3151
  • Fax:
Mailing address:
  • Phone: 330-745-3151
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number17648-NP
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: