Provider Demographics
NPI:1972626174
Name:HEMATOLOGY & ONCOLOGY ASSOCIATES, INC
Entity Type:Organization
Organization Name:HEMATOLOGY & ONCOLOGY ASSOCIATES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:GINA
Authorized Official - Middle Name:M
Authorized Official - Last Name:NUSKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-453-9993
Mailing Address - Street 1:1455 HARRISON AVE NW
Mailing Address - Street 2:SUITE 105
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44708-2621
Mailing Address - Country:US
Mailing Address - Phone:330-453-9993
Mailing Address - Fax:330-453-9996
Practice Address - Street 1:1455 HARRISON AVE NW
Practice Address - Street 2:SUITE 105
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44708-2621
Practice Address - Country:US
Practice Address - Phone:330-453-9993
Practice Address - Fax:330-453-9996
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-10
Last Update Date:2010-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2064297Medicaid
OH2064297Medicaid
OH4169790001Medicare NSC
OHHE9293071Medicare PIN