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Contact Information

NEOGERIATRICS
4808 MUNSON ST NW
CANTON, OH44718
 Phone: 330-830-8666
 Fax: 330-832-3499
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Geriatric Medicine

207RG0300X 11 Physician/Internal Medicine
Indicates primary specialty

NPI Profile & details for NEOGERIATRICS

NPI # 1124259536
LBN Legal business name NEOGERIATRICS
Authorized official JYOTHI GUDLA - (PRESIDENT)
Entity Organization
Organization subpart 1 No
Enumeration date 08/03/2009
Last updated 11/19/2024 - More than a year ago
Identifiers
OH License # 35-083145
OH Medicaid 2940956
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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