Provider Demographics
NPI:1275722894
Name:NESDININC.
Entity Type:Organization
Organization Name:NESDININC.
Other - Org Name:NESDININC.
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:NESTOR
Authorized Official - Middle Name:G
Authorized Official - Last Name:GAYOMALI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:440-934-5443
Mailing Address - Street 1:PO BOX 296
Mailing Address - Street 2:
Mailing Address - City:AVON LAKE
Mailing Address - State:OH
Mailing Address - Zip Code:44012-0296
Mailing Address - Country:US
Mailing Address - Phone:440-934-5443
Mailing Address - Fax:440-934-1077
Practice Address - Street 1:5311 MEADOW LANE CT
Practice Address - Street 2:STE 3
Practice Address - City:ELYRIA
Practice Address - State:OH
Practice Address - Zip Code:44035-1485
Practice Address - Country:US
Practice Address - Phone:440-934-5443
Practice Address - Fax:440-934-1077
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-19
Last Update Date:2011-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35074130207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHSP03051Medicare PIN