Provider Demographics
NPI:1184651465
Name:DIDADO, CYNTHIA (CNP)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:
Last Name:DIDADO
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 6472
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44312-0472
Mailing Address - Country:US
Mailing Address - Phone:216-313-0154
Mailing Address - Fax:330-699-0781
Practice Address - Street 1:1243 PORTAGE LINE RD
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44312-5704
Practice Address - Country:US
Practice Address - Phone:216-313-0154
Practice Address - Fax:330-699-0781
Is Sole Proprietor?:No
Enumeration Date:2006-06-26
Last Update Date:2018-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHNP-0660363LP2300X
OHNP-06660363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000342117OtherANTHEM
OH2338849Medicaid
OH000000342117OtherANTHEM
OHP64696Medicare UPIN