=====================================================
General NPI Number Information
=====================================================
NPI Number | 1760909436
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | NICOLE DIDONATO P.A.
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/24/2017
-----------------------------------------------------
Last Update Date | 10/20/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 18586 5TH ST
-----------------------------------------------------
City | BELOIT
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 44609-9799
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 330-938-3333
-----------------------------------------------------
Fax | 330-938-9487
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2000 AUBURN DR. STE. 350
-----------------------------------------------------
City | BEACHWOOD
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 44122-4327
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 440-646-1600
-----------------------------------------------------
Fax | 440-646-1505
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363A00000X
-----------------------------------------------------
Taxonomy Name | Physician Assistant
-----------------------------------------------------
License Number | 50.005204RX
-----------------------------------------------------
License Number State | OH
-----------------------------------------------------