Northeastern Ohio Infectious Disease Association Inc

Organization Active NPI Infectious Disease Physician · Youngstown, OH

NPI 1497769707 · NPPES record last updated Dec 17, 2014

Key facts

NPI
1497769707
Entity type
Organization (NPI type 2)
Primary specialty
Infectious Disease Physician 207RI0200X
Legal business name
NORTHEASTERN OHIO INFECTIOUS DISEASE ASSOCIATION INC
Practice address
540 Parmalee Ave
Ste. 610
Youngstown, OH 44510-1605
Phone
(330) 744-4369
Fax
(330) 744-1728
NPI assigned
Jul 29, 2006
Organization subpart
No

Authorized official

Name
Dr. Anthony F. Cutrona, MD
Title
Ceo
Phone
(330) 744-4369

Corporate family (same tax ID) 2

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners 16

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

Medicare participation

Medicare fee-for-service enrollment
Enrolled in OH

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20061013000102 OH Part B Supplier - Clinic/Group Practice 5799781829 Receives reassigned benefits from 14 practitioners
Practice locations: Boardman, OH

National Provider Directory

Tax ID family
Northeastern Ohio Infectious Disease Association Inc (3 organizations share this tax ID)

Locations

540 Parmalee Ave
Ste 610
Youngstown, OH 44510
Phone (330) 480-2078

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Infectious Disease Physician
Group: 193400000X SINGLE SPECIALTY GROUP
207RI0200X Yes

Addresses

Primary practice location

540 Parmalee Ave
Ste. 610
Youngstown, OH 44510-1605

Mailing address

PO Box 2163
Youngstown, OH 44504-0163
Phone (330) 744-4369

Other identifiers

IdentifierTypeStateIssuer
0981817MedicaidOH

Other providers in Youngstown, OH

All providers in Youngstown, OH · Infectious Disease Physician in Ohio

Sources for this page

Verify at the official NPI Registry.