Healthcare Provider Details

I. General information

NPI: 1245810100
Provider Name (Legal Business Name): KATHRYN ABELE DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/13/2021
Last Update Date: 06/12/2024
Certification Date: 06/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

303 CHESTNUT COMMONS DR
ELYRIA OH
44035-9607
US

IV. Provider business mailing address

303 CHESTNUT COMMONS DR
ELYRIA OH
44035-9607
US

V. Phone/Fax

Practice location:
  • Phone: 440-336-9444
  • Fax:
Mailing address:
  • Phone: 440-336-9444
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number34.017086
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: