=====================================================
General NPI Number Information
=====================================================
NPI Number | 1902105604
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | DARLEEN ABADCO DPM
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/21/2011
-----------------------------------------------------
Last Update Date | 05/09/2022
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1300 S. CANFIELD NILES RD
-----------------------------------------------------
City | AUSTINTOWN
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 44515
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 330-792-6519
-----------------------------------------------------
Fax | 330-792-9911
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 4048 SAINT ANDREWS CT APT 4
-----------------------------------------------------
City | CANFIELD
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 44406-9079
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 337-654-4320
-----------------------------------------------------
Fax | 330-746-8581
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 213ES0103X
-----------------------------------------------------
Taxonomy Name | Foot & Ankle Surgery Podiatrist
-----------------------------------------------------
License Number | 003621
-----------------------------------------------------
License Number State | OH
-----------------------------------------------------