Healthcare Provider Details

I. General information

NPI: 1164821583
Provider Name (Legal Business Name): JOSEPH NEGRI
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/21/2014
Last Update Date: 09/29/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3716 RIDGE MILL DR
HILLIARD OH
43026-9231
US

IV. Provider business mailing address

790 REMINGTON BLVD
BOLINGBROOK IL
60440-4909
US

V. Phone/Fax

Practice location:
  • Phone: 614-771-8537
  • Fax: 614-771-8538
Mailing address:
  • Phone: 630-296-2222
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOT007818
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: