Provider Demographics
NPI:1265618151
Name:CLEVELAND RENAL ASSOCIATES LTD
Entity type:Organization
Organization Name:CLEVELAND RENAL ASSOCIATES LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:HAIFA
Authorized Official - Middle Name:
Authorized Official - Last Name:HANNA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:216-901-5706
Mailing Address - Street 1:6701 ROCKSIDE RD
Mailing Address - Street 2:SUITE 365
Mailing Address - City:INDEPENDENCE
Mailing Address - State:OH
Mailing Address - Zip Code:44131-2358
Mailing Address - Country:US
Mailing Address - Phone:216-901-5706
Mailing Address - Fax:216-901-6201
Practice Address - Street 1:6701 ROCKSIDE RD
Practice Address - Street 2:SUITE 365
Practice Address - City:INDEPENDENCE
Practice Address - State:OH
Practice Address - Zip Code:44131-2358
Practice Address - Country:US
Practice Address - Phone:216-901-5706
Practice Address - Fax:216-901-6201
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-10
Last Update Date:2012-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35034136207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHCL9307492Medicare Oscar/Certification
OHCL9307492Medicare PIN
OHHA0396993Medicare PIN