Individual
GERALD A. MATTEUCCI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1044 BELMONT AVE, YOUNGSTOWN, OH 44504-1006
(330) 286-5330
(330) 286-5396
Mailing address
4135 BOARDMAN-CANFIELD ROAD, SUITE 101, CANFIELD, OH 44406-7010
(330) 286-5330
(330) 286-5396
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
35-056325
OH
207LP2900X
Pain Medicine (Anesthesiology) Physician
35-056325
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
050090936
MEDICARE RAILROAD
OH
05
—
0770189
—
OH
Enumeration date
06/08/2006
Last updated
07/13/2010
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