Healthcare Provider Details

I. General information

NPI: 1811462476
Provider Name (Legal Business Name): RYAN T DELBENE PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/10/2018
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1335 BELMONT AVE
YOUNGSTOWN OH
44504-1135
US

IV. Provider business mailing address

100 DEBARTOLO PL STE 200
YOUNGSTOWN OH
44512-6095
US

V. Phone/Fax

Practice location:
  • Phone: 234-287-9154
  • Fax: 330-747-2211
Mailing address:
  • Phone: 330-729-8146
  • Fax: 330-965-5229

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number50.005727RX
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: