Provider Demographics
NPI:1699402180
Name:PAPPAGALLO, ANDY JOSEPH (FNP)
Entity type:Individual
Prefix:MR
First Name:ANDY
Middle Name:JOSEPH
Last Name:PAPPAGALLO
Suffix:
Gender:M
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:6793 FOX CROSSING CT
Mailing Address - Street 2:
Mailing Address - City:AUSTINTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44515-5614
Mailing Address - Country:US
Mailing Address - Phone:330-559-2208
Mailing Address - Fax:
Practice Address - Street 1:3499 BELMONT AVE
Practice Address - Street 2:
Practice Address - City:YOUNGSTOWN
Practice Address - State:OH
Practice Address - Zip Code:44505-1807
Practice Address - Country:US
Practice Address - Phone:330-759-0085
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-04
Last Update Date:2022-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.0031986363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHAPRN.CNP.0031986OtherOHIO BOARD OF NURSING