Paul J Amendola
Individual provider Active NPI Athletic Trainer · Fairlawn, OH
NPI 1740532019 · NPPES record last updated Oct 10, 2012
Key facts
- NPI
- 1740532019
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Athletic Trainer 2255A2300X
- License
- 003349 (OH)
- Practice address
- 2660 W Market St Ste 300
Fairlawn, OH 44333-4209 - Phone
- (330) 869-2635
- NPI assigned
- Oct 10, 2012
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 003349 | OH | MD | Athletic Trainer |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | 003349 | OH | Yes |
Addresses
Primary practice location
2660 W Market St Ste 300
Fairlawn, OH 44333-4209
Mailing address
2660 W Market St Ste 300
Fairlawn, OH 44333-4209
Other providers in Fairlawn, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 10, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.