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General NPI Number Information
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NPI Number | 1578404315
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Entity Type | Individual
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Provider Name | DAVID DISABATO PHD
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Gender | Male
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Dates
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Enumeration Date | 04/04/2026
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Last Update Date | 04/04/2026
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Provider Practice Location Address
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Address Line | 12608 STATE RD STE 1
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City | NORTH ROYALTON
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State | OH
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Zip | 44133-3281
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Country | US
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Telephone | 440-907-1141
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Fax |
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Provider Business Mailing Address
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Address Line | 12500 EDGEWATER DR APT 1403
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City | LAKEWOOD
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State | OH
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Zip | 44107-1656
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Country | US
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Telephone | 414-801-8489
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | P.08411
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License Number State | OH
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