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General NPI Number Information
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NPI Number | 1396563706
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Entity Type | Individual
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Provider Name | KASEY ELIZABETH DESALVO PA-C
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Gender | Female
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Dates
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Enumeration Date | 10/03/2024
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Last Update Date | 12/29/2025
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Provider Practice Location Address
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Address Line | 5480 NORQUEST BLVD
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City | YOUNGSTOWN
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State | OH
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Zip | 44515-1820
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Country | US
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Telephone | 330-779-0545
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Fax |
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Provider Business Mailing Address
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Address Line | 10802 KIRK RD
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City | NORTH JACKSON
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State | OH
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Zip | 44451-9742
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Country | US
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Telephone | 330-519-5402
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | MA065976
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License Number State | PA
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