Individual
MR. YAZAN K JADALLAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1044 BELMONT AVENUE, YOUNGSTOWN, OH 44501
(330) 746-7211
(330) 480-3916
Mailing address
5700 DARROW ROAD, SUITE 106, HUDSON, OH 44236-5021
(330) 656-5911
(330) 656-5901
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
35 079101J
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
101307865-0001
PENNSYLVANIA MEDICAID
OH
01
—
101307865-0002
PENNSYLVANIA MEDICAID
OH
01
—
101307865-0003
PENNSYLVANIA MEDICAID
OH
05
—
2258435
—
OH
01
—
P00375999
RAILROAD MEDICARE
OH
Enumeration date
12/13/2005
Last updated
01/10/2008
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