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General NPI Number Information
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NPI Number | 1720046535
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Entity Type | Organization
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Legal Business Name | THE REGIONAL CANCER CENTER NEO
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Dates
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Enumeration Date | 05/02/2006
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 2412 LAKE AVE
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City | ASHTABULA
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State | OH
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Zip | 44004-4977
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Country | US
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Telephone | 440-997-4554
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Fax |
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Provider Business Mailing Address
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Address Line | 2500 W 12TH ST
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City | ERIE
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State | PA
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Zip | 16505-4508
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Country | US
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Telephone | 814-838-9000
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Fax |
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Authorized Official
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Title or Position | CFO
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Name | KANDY A SUSI
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Credential |
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Telephone | 814-838-9000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2085R0001X
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Taxonomy Name | Radiation Oncology Physician
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License Number |
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License Number State |
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