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General NPI Number Information
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NPI Number | 1578707659
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Entity Type | Organization
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Legal Business Name | ST CYRIL PAIN CLINIC
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Dates
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Enumeration Date | 04/21/2009
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Last Update Date | 11/02/2012
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Provider Practice Location Address
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Address Line | 2600 ELM RD NE
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City | CORTLAND
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State | OH
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Zip | 44410-9393
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Country | US
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Telephone | 330-729-0111
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Fax | 330-729-1333
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Provider Business Mailing Address
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Address Line | 909 SAHARA TRL STE B
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City | YOUNGSTOWN
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State | OH
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Zip | 44514-3691
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Country | US
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Telephone | 330-729-0111
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Fax | 330-729-1333
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Authorized Official
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Title or Position | OWNER
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Name | GEORGE NAGUIB ANDREWS
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Credential | M.D.
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Telephone | 216-509-0842
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208VP0000X
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Taxonomy Name | Pain Medicine Physician
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License Number | 35090324
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License Number State | OH
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