Healthcare Provider Details

I. General information

NPI: 1477175651
Provider Name (Legal Business Name): EMILY FOREIT P.A.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/11/2020
Last Update Date: 10/27/2025
Certification Date: 10/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4124 MUNSON ST
CANTON OH
44718-4804
US

IV. Provider business mailing address

2000 AUBURN DR. STE. 350
BEACHWOOD OH
44122-4327
US

V. Phone/Fax

Practice location:
  • Phone: 234-410-7546
  • Fax: 234-410-7549
Mailing address:
  • Phone: 440-646-1600
  • Fax: 440-646-1505

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number50.006999RX
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: