| Organization Name: | NEPHROLOGY ASSOCIATES OF CLEVELAND, LTD. |
| NPI Number: | 1033206743 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | DIANE P WISH (VICE PRESIDENT) |
| Mailing Address: | 4877 Galaxy Pkwy Suite A Warrensville Heights |
| State: | OH US |
| Postal Code: | 441285972 |
| Phone Number: | 2163785050 |
| Fax Number: | 2163785060 |
| NPI Enumeration Date: | 10/06/2006 |
| NPI Last Update Date: | 03/07/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QE0700X |
| License Number: | 0430DC |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OH |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | End-Stage Renal Disease (ESRD) Treatment |
| Taxonomy Definition: | |