Healthcare Provider Details

I. General information

NPI: 1306596010
Provider Name (Legal Business Name): MATTHEW CEFALU
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/25/2022
Last Update Date: 07/20/2026
Certification Date: 07/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5890 MAYFAIR RD
NORTH CANTON OH
44720-4442
US

IV. Provider business mailing address

5890 MAYFAIR RD
NORTH CANTON OH
44720
US

V. Phone/Fax

Practice location:
  • Phone: 330-305-2200
  • Fax:
Mailing address:
  • Phone: 330-305-2200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number35155815
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: