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General NPI Number Information
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NPI Number | 1790585578
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Entity Type | Individual
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Provider Name | THOMAS JOHN DUFFY FNP
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Gender | Male
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Dates
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Enumeration Date | 03/19/2025
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Last Update Date | 03/21/2025
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Provider Practice Location Address
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Address Line | 250 DEBARTOLO PL STE B
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City | YOUNGSTOWN
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State | OH
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Zip | 44512-7004
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Country | US
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Telephone | 234-375-0359
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Fax | 330-758-3282
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Provider Business Mailing Address
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Address Line | 100 DEBARTOLO PL STE 200
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City | YOUNGSTOWN
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State | OH
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Zip | 44512-6095
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Country | US
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Telephone | 330-729-8146
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Fax | 220-965-5229
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | APRN.CNP.0038613
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License Number State | OH
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