Basic Information
| Provider Information | |||||||||
| NPI: | 1942696547 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BITONTE | ||||||||
| FirstName: | AMELIA | ||||||||
| MiddleName: | HYLAND | ||||||||
| NamePrefix: | |||||||||
| NameSuffix: | |||||||||
| Credential: | D.O. | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | BOBER | ||||||||
| OtherFirstName: | AMELIA | ||||||||
| OtherMiddleName: | HYLAND | ||||||||
| OtherNamePrefix: | |||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | D.O. | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 55 ARCH ST | ||||||||
| Address2: | STE 1B | ||||||||
| City: | AKRON | ||||||||
| State: | OH | ||||||||
| PostalCode: | 443041423 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3303753315 | ||||||||
| FaxNumber: | 3303757779 | ||||||||
| Practice Location | |||||||||
| Address1: | 55 ARCH ST | ||||||||
| Address2: | SUITE 1B | ||||||||
| City: | AKRON | ||||||||
| State: | OH | ||||||||
| PostalCode: | 44304 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3303753315 | ||||||||
| FaxNumber: | 3303757779 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/09/2015 | ||||||||
| LastUpdateDate: | 07/30/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 207R00000X | 34.013490 | OH | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
ID Information
| ID | Type | State | Issuer | Description | 58.007021 | 01 | OH | TRAINING CERTIFICATE NUMBER | OTHER |