Provider Demographics
NPI:1790376812
Name:LAVITA NEPHROLOGY CONSULTANTS
Entity Type:Organization
Organization Name:LAVITA NEPHROLOGY CONSULTANTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:BUTHAYNA
Authorized Official - Middle Name:ALKHATIB
Authorized Official - Last Name:DINARY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:440-773-2987
Mailing Address - Street 1:PO BOX 451400
Mailing Address - Street 2:
Mailing Address - City:WESTLAKE
Mailing Address - State:OH
Mailing Address - Zip Code:44145
Mailing Address - Country:US
Mailing Address - Phone:440-773-2987
Mailing Address - Fax:
Practice Address - Street 1:25200 CENTER RIDGE RD SUITE 2100
Practice Address - Street 2:
Practice Address - City:WESTLAKE
Practice Address - State:OH
Practice Address - Zip Code:44145
Practice Address - Country:US
Practice Address - Phone:440-331-5962
Practice Address - Fax:440-331-5914
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-01
Last Update Date:2021-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Single Specialty