Healthcare Provider Details

I. General information

NPI: 1336706506
Provider Name (Legal Business Name): NORTH EAST OHIO ENDOSCOPY CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/23/2019
Last Update Date: 07/18/2023
Certification Date: 07/18/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4665 BELPAR ST NW
CANTON OH
44718-3602
US

IV. Provider business mailing address

1622 E MARKET ST
WARREN OH
44483-6613
US

V. Phone/Fax

Practice location:
  • Phone: 330-493-1480
  • Fax: 330-493-6805
Mailing address:
  • Phone: 330-399-7215
  • Fax: 330-399-2411

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ADEL YOUSSEF
Title or Position: PRESIDENT
Credential: MD
Phone: 330-399-7215