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General NPI Number Information
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NPI Number | 1033205216
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Entity Type | Organization
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Legal Business Name | DERMATOLOGY ASSOCIATES OF YOUNGSTOWN INC
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Dates
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Enumeration Date | 10/05/2006
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Last Update Date | 10/30/2007
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Provider Practice Location Address
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Address Line | 7430 SOUTHERN BLVD
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City | YOUNGSTOWN
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State | OH
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Zip | 44512
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Country | US
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Telephone | 330-726-9141
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Fax | 330-726-7140
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Provider Business Mailing Address
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Address Line | 7430 SOUTHERN BLVD
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City | YOUNGSTOWN
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State | OH
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Zip | 44512
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Country | US
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Telephone | 330-726-9141
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Fax | 330-726-7140
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Authorized Official
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Title or Position | PRESIDENT
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Name | DANIEL W HANDEL
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Credential | MD
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Telephone | 330-726-9141
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | 35032735H
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License Number State | OH
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