Healthcare Provider Details

I. General information

NPI: 1942761473
Provider Name (Legal Business Name): JESSE DRAPEKIN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/27/2019
Last Update Date: 08/11/2025
Certification Date: 08/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1044 BELMONT AVE
YOUNGSTOWN OH
44504-1006
US

IV. Provider business mailing address

1044 BELMONT AVE
YOUNGSTOWN OH
44504-1006
US

V. Phone/Fax

Practice location:
  • Phone: 330-480-8015
  • Fax: 330-480-8049
Mailing address:
  • Phone: 330-480-8015
  • Fax: 330-480-8049

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number35.145539
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number125.074021
License Number StateIL
# 4
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number35.145539
License Number StateOH
# 5
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number35.145539
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: