Healthcare Provider Details

I. General information

NPI: 1649135070
Provider Name (Legal Business Name): SHAKHNOZA YAGFAROVA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/18/2025
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2335 GREENSBURG RD
NORTH CANTON OH
44720-1415
US

IV. Provider business mailing address

2335 GREENSBURG RD
NORTH CANTON OH
44720-1415
US

V. Phone/Fax

Practice location:
  • Phone: 330-805-0656
  • Fax:
Mailing address:
  • Phone: 330-805-0656
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code172A00000X
TaxonomyDriver
License NumberVT643526
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: