Healthcare Provider Details

I. General information

NPI: 1013996420
Provider Name (Legal Business Name): MAUREEN YVONNE YABLONSKI M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/13/2006
Last Update Date: 03/18/2021
Certification Date: 03/18/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1717 W MAIN ST STE 202
NEWARK OH
43055-1362
US

IV. Provider business mailing address

1717 W MAIN ST STE 202
NEWARK OH
43055-1362
US

V. Phone/Fax

Practice location:
  • Phone: 220-564-7970
  • Fax: 220-564-7971
Mailing address:
  • Phone: 220-564-7970
  • Fax: 220-564-7971

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License NumberOH35-06-0066
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: