Healthcare Provider Details

I. General information

NPI: 1487279857
Provider Name (Legal Business Name): NIMIT DALAL
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/11/2020
Last Update Date: 03/18/2025
Certification Date: 03/18/2025
Deactivation Date: 01/18/2022
Reactivation Date: 03/24/2022

III. Provider practice location address

1340 BELMONT AVE STE 2300
YOUNGSTOWN OH
44504-1129
US

IV. Provider business mailing address

1340 BELMONT AVE STE 2300
YOUNGSTOWN OH
44504-1129
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 Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number35.152533
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: