Healthcare Provider Details

I. General information

NPI: 1912954389
Provider Name (Legal Business Name): HASIT P PANDYA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/30/2006
Last Update Date: 08/04/2020
Certification Date: 08/04/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1340 BELMONT AVE SUITE 2300
YOUNGSTOWN OH
44504-1191
US

IV. Provider business mailing address

1340 BELMONT AVE THE KIDNEY GROUP SUITE 2300
YOUNGSTOWN OH
44504-1191
US

V. Phone/Fax

Practice location:
  • Phone: 330-746-1488
  • Fax: 330-746-5611
Mailing address:
  • Phone: 330-746-1488
  • Fax: 330-746-5611

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number238068
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License NumberMD434612
License Number StatePA
# 3
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number35087062
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: