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General NPI Number Information
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NPI Number | 1770698466
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Entity Type | Organization
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Legal Business Name | CHILDREN'S CARE CENTER FOR BLOOD & CANCER
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Dates
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Enumeration Date | 08/20/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 500 GYPSY LN
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City | YOUNGSTOWN
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State | OH
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Zip | 44504-1315
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Country | US
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Telephone | 330-884-3955
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Fax | 330-884-3861
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Provider Business Mailing Address
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Address Line | 500 GYPSY LN
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City | YOUNGSTOWN
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State | OH
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Zip | 44504-1315
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Country | US
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Telephone | 330-884-3955
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Fax | 330-884-3861
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Authorized Official
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Title or Position | BUSINESS MANAGER
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Name | LUCINE SALEH
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Credential |
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Telephone | 330-884-3955
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2080P0207X
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Taxonomy Name | Pediatric Hematology & Oncology Physician
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License Number |
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License Number State |
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