Provider Demographics
NPI:1609171222
Name:NORTH OHIO KIDNEY SPECIALISTS LLC
Entity Type:Organization
Organization Name:NORTH OHIO KIDNEY SPECIALISTS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BASHAR
Authorized Official - Middle Name:
Authorized Official - Last Name:ALALAO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:330-510-1461
Mailing Address - Street 1:1461 SUMMERWOOD DR
Mailing Address - Street 2:
Mailing Address - City:BROADVIEW HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44147-2846
Mailing Address - Country:US
Mailing Address - Phone:330-510-1461
Mailing Address - Fax:330-818-2558
Practice Address - Street 1:201 5TH ST NE
Practice Address - Street 2:SUIT 14
Practice Address - City:BARBERTON
Practice Address - State:OH
Practice Address - Zip Code:44203-3017
Practice Address - Country:US
Practice Address - Phone:330-510-1461
Practice Address - Fax:330-818-2558
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-12
Last Update Date:2013-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-093227172P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes172P00000XOther Service ProvidersNaprapathGroup - Single Specialty