MEDICARE: NORTHEASTERN OHIO INFECTIOUS DISEASE ASSOCIATION INC

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	207RI0200X	Infectious Disease Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1497769707
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NORTHEASTERN OHIO INFECTIOUS DISEASE ASSOCIATION INC

Provider Business Mailing Address
First Line	:	PO BOX 2163
Second Line	:
City	:	YOUNGSTOWN
State	:	OH
Zip	:	44504-0163
Country	:	US
Telephone Number	:	330-744-4369
Fax Number	:	330-744-1728

Provider Business Practice Location Address
First Line	:	540 PARMALEE AVE
Second Line	:	STE. 610
City	:	YOUNGSTOWN
State	:	OH
Zip	:	44510-1605
Country	:	US
Telephone Number	:	330-744-4369
Fax Number	:	330-744-1728

Authorized Official
Title or Position	:	CEO
Name	:	DR. ANTHONY F. CUTRONA
Credential	:	MD
Telephone Number	:	330-744-4369

Provider Enumeration Date	:	07/29/2006
Last Update Date	:	12/17/2014

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