Organization
WALTER J PASSARELLO, DO LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WALTER J PASSARELLO D.O. (OWNER)
(330) 757-7888
Entity
Organization
Contact information
Practice address
8064 SOUTH AVE, BOARDMAN, OH 44512-6153
(330) 757-7888
(330) 757-4912
Mailing address
3584 TIMBERBROOKE TRL, POLAND, OH 44514-5321
(330) 757-7888
(330) 757-4912
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
34006450
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2101120
—
OH
Enumeration date
05/11/2007
Last updated
08/22/2020
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