Provider Demographics
NPI:1992046429
Name:YANKE, JOSEPH N (CPO, LPO)
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:N
Last Name:YANKE
Suffix:
Gender:M
Credentials:CPO, LPO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1261 MONROE ST NW
Mailing Address - Street 2:
Mailing Address - City:NEW PHILADELPHIA
Mailing Address - State:OH
Mailing Address - Zip Code:44663-4139
Mailing Address - Country:US
Mailing Address - Phone:330-343-8343
Mailing Address - Fax:330-602-2547
Practice Address - Street 1:1261 MONROE ST NW
Practice Address - Street 2:
Practice Address - City:NEW PHILADELPHIA
Practice Address - State:OH
Practice Address - Zip Code:44663-4139
Practice Address - Country:US
Practice Address - Phone:330-343-8343
Practice Address - Fax:330-602-2547
Is Sole Proprietor?:No
Enumeration Date:2013-03-07
Last Update Date:2013-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHLPO16222Z00000X, 224P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224P00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersProsthetist
No222Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2002880Medicaid