Healthcare Provider Details

I. General information

NPI: 1912297490
Provider Name (Legal Business Name): NELY ALDRICH M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/18/2011
Last Update Date: 11/14/2025
Certification Date: 11/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5655 HUDSON DRIVE STE. 301
HUDSON OH
44236-4454
US

IV. Provider business mailing address

2000 AUBURN DR STE. 350
BEACHWOOD OH
44122-4327
US

V. Phone/Fax

Practice location:
  • Phone: 330-653-3376
  • Fax: 330-653-3378
Mailing address:
  • Phone: 440-646-1600
  • Fax: 440-646-1505

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number35126160
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number35.126160
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: