Provider Demographics
NPI:1760634653
Name:GAMBONE, JOSEPH N
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:N
Last Name:GAMBONE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1325 CHURCHILL HUBBARD RD
Mailing Address - Street 2:
Mailing Address - City:YOUNGSTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44505-1346
Mailing Address - Country:US
Mailing Address - Phone:330-759-5904
Mailing Address - Fax:330-759-8709
Practice Address - Street 1:3725 CLEVELAND MASSILLON RD
Practice Address - Street 2:
Practice Address - City:NORTON
Practice Address - State:OH
Practice Address - Zip Code:44203-5614
Practice Address - Country:US
Practice Address - Phone:330-861-0710
Practice Address - Fax:330-753-2051
Is Sole Proprietor?:No
Enumeration Date:2008-10-22
Last Update Date:2008-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCOND2009033235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist