Healthcare Provider Details

I. General information

NPI: 1437177979
Provider Name (Legal Business Name): JOEL S ENRIQUEZ MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/17/2006
Last Update Date: 11/30/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5500 MARKET ST STE 119
YOUNGSTOWN OH
44512-2616
US

IV. Provider business mailing address

122 GLOVER RD
NEW CASTLE PA
16105-1224
US

V. Phone/Fax

Practice location:
  • Phone: 724-824-4096
  • Fax: 724-269-9476
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License NumberMD032828E
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberMD032828E
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: