MEDICARE: LATEEF MEALY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	376J00000X	Homemaker	UT186161	OH

General Provider Information

NPI Number	:	1043021900
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LATEEF MEALY

Provider Business Mailing Address
First Line	:	1700 15TH ST SE
Second Line	:
City	:	MASSILLON
State	:	OH
Zip	:	44646-8124
Country	:	US
Telephone Number	:	330-232-5589
Fax Number	:

Provider Business Practice Location Address
First Line	:	1700 15TH ST SE
Second Line	:
City	:	MASSILLON
State	:	OH
Zip	:	44646-8124
Country	:	US
Telephone Number	:	330-232-5589
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/18/2025
Last Update Date	:	01/18/2025

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Directions to “ LATEEF MEALY ” Practice Location

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