Organization Active NPI

Manal H Assaad

  • Specialist
  • Canton, OH
National Provider Identifier
1164669065
Registry record updated Jun 19, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
35074361 Issued in OH
Legal business name
MANAL H ASSAAD
Practice address
4360 Fulton Dr NW
Suite a
Canton, OH 44718-2878
Phone
(330) 433-0000
NPI assigned
Jan 14, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Bonnie Truett
Title
Office Manager
Phone
(330) 433-0000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X 35074361 OH Primary

Addresses

Primary practice location

4360 Fulton Dr NW
Suite a
Canton, OH 44718-2878

Mailing address

4360 Fulton Dr NW
Suite a
Canton, OH 44718-2878

Other identifiers 1

IdentifierTypeStateIssuer
2127559MedicaidOH

National Provider Directory

National Provider Directory

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1231891200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1403136000000",
    "number": "1164669065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4360 FULTON DR NW",
            "address_2": "SUITE A",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447182878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4360 FULTON DR NW",
            "address_2": "SUITE A",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447182878",
            "telephone_number": "330-433-0000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MANAL H ASSAAD",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-01-14",
        "last_updated": "2014-06-19",
        "status": "A",
        "authorized_official_last_name": "TRUETT",
        "authorized_official_first_name": "BONNIE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "330-433-0000"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "OH",
            "license": "35074361",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2127559",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.