Dermatology Associates of Canton, LLC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

350755495 Issued in OH

Legal business name

DERMATOLOGY ASSOCIATES OF CANTON, LLC

Practice address

4677 Fulton Dr NW
Canton, OH 44718-2379

Phone

(330) 491-4700

Fax

(330) 497-0667

NPI assigned

Jun 21, 2013

Organization subpart

No

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

Authorized official

Name

Lisa Marie Sayoc, MDNPI 1124095682

Title

Physician

Phone

(330) 491-4700

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Lisa Marie Sayoc, MD

  • Dermatology Physician
  • Canton, OH
  • NPI 1124095682
  NPD (past) Authorized official

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

{
    "created_epoch": "1371772800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1399852800000",
    "number": "1386083467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4677 FULTON DR NW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447182379",
            "telephone_number": "330-491-4700",
            "fax_number": "330-497-0667"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4677 FULTON DR NW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447182379",
            "telephone_number": "330-491-4700",
            "fax_number": "330-497-0667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DERMATOLOGY ASSOCIATES OF CANTON, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-06-21",
        "last_updated": "2014-05-12",
        "status": "A",
        "authorized_official_last_name": "SAYOC",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "330-491-4700",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "OH",
            "license": "350755495",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2247232",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amanda Depasquale, CHHA
• Jessica Depasquale
• Lavonia T Depasquale, CT, LCDC III
• Breanna Depew, OT
• Lester Scott Depriest
• Michael Francis Derosa, MD
• Salvatore Desantis, RPH
• Christina Despres
• Linda Detamore
• Gretchen Deubner, CRNA

• Dermatology Physician in Canton, OH
• Providers in Canton, OH by specialty
• Dermatology Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 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.