Individual
KACEY DIVINCENZO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2473 NORTH RD NE, WARREN, OH 44483-3054
(330) 372-2251
Mailing address
517 OPHELIA ST, NEWTON FALLS, OH 44444-1470
(330) 980-2237
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
50.007802RX
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0001385
—
OH
Enumeration date
09/07/2022
Last updated
12/30/2025
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