Neuendorf, Tracy L

Neuendorf, Tracy L is an individual health care provider with primary practice located at 1011 Boardman Canfield Rd , Youngstown OH 44512-4226. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Addiction Medicine, Allopathic & Osteopathic Physicians / Pain Medicine. Allopathic & Osteopathic Physicians / Pain Medicine is his primary health care specialty. Neuendorf, Tracy L can be contacted via phone (330) 629-2888.

Contact Information

Primary practice address
1011 Boardman Canfield Rd Youngstown OH 44512-4226
Phone: (330) 629-2888
Fax: (330) 629-8940
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Addiction Medicine 207LA0401X 34.003509 Ohio
Allopathic & Osteopathic Physicians / Pain Medicine 207LP2900X 34-00-3509-N Ohio

Profile Details

NPI number 1275509275
LBN Legal business name Neuendorf, Tracy L
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 28th, 2006
Last updated Apr 30th, 2020 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1275509275 NPPES
Ohio Other 000403561 HIGHMARK BC/BS
Ohio MEDICAID 0010273680005 HIGHMARK BC/BS
Ohio Other 127674 HIGHMARK BC/BS
Ohio MEDICAID 0601834 HIGHMARK BC/BS

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