Healthcare Provider Details

I. General information

NPI: 1437626645
Provider Name (Legal Business Name): SAVANNAH MARIA BARBERA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/25/2018
Last Update Date: 10/26/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

567 WABASH AVE NW
NEW PHILADELPHIA OH
44663-4143
US

IV. Provider business mailing address

130 W SLINGLUFF AVE
DOVER OH
44622-2749
US

V. Phone/Fax

Practice location:
  • Phone: 330-343-3050
  • Fax:
Mailing address:
  • Phone: 330-407-3533
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number171M00000X
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number251B00000X
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: