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General NPI Number Information
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NPI Number | 1710176706
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Entity Type | Organization
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Legal Business Name | ASSOCIATES IN FAMILY MEDICINE, LTD
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Dates
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Enumeration Date | 10/16/2007
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Last Update Date | 08/03/2010
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Provider Practice Location Address
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Address Line | 80 MARWOOD CIR
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City | BOARDMAN
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State | OH
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Zip | 44512-6249
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Country | US
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Telephone | 330-758-2346
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Fax | 330-758-8698
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Provider Business Mailing Address
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Address Line | PO BOX 3538
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City | BOARDMAN
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State | OH
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Zip | 44513-3538
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Country | US
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Telephone | 330-758-2346
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Fax | 330-758-8698
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Authorized Official
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Title or Position | PRESIDENT
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Name | ADRIAN IERACI
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Credential | D.O.
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Telephone | 330-758-2346
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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 |
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License Number State |
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