Healthcare Provider Details

I. General information

NPI: 1952312704
Provider Name (Legal Business Name): KAREN M MAFFEI R.D., L.D., C.D.E
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/10/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2031 BELMONT AVE
YOUNGSTOWN OH
44505-2401
US

IV. Provider business mailing address

3609 S DUCK CREEK RD
NORTH JACKSON OH
44451-9759
US

V. Phone/Fax

Practice location:
  • Phone: 330-740-9200
  • Fax:
Mailing address:
  • Phone: 330-538-2169
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number3480
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: