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General NPI Number Information
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NPI Number | 1063682052
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Entity Type | Organization
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Legal Business Name | NICHOLAS P DEPIZZO DO INC
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Dates
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Enumeration Date | 03/05/2008
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Last Update Date | 03/18/2008
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Provider Practice Location Address
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Address Line | 4991 BELMONT AVE
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City | YOUNGSTOWN
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State | OH
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Zip | 44505-1017
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Country | US
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Telephone | 330-759-0435
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Fax |
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Provider Business Mailing Address
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Address Line | 4991 BELMONT AVE
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City | YOUNGSTOWN
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State | OH
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Zip | 44505-1017
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Country | US
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Telephone | 330-759-0435
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. NICHOLAS DEPIZZO
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Credential | D.O.
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Telephone | 330-759-0435
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 34007530D
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License Number State | OH
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