MEDICARE: NEWMAN NIMUBAH DOLO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106E00000X	Assistant Behavior Analyst	9626667508ND	OH

General Provider Information

NPI Number	:	1306718044
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NEWMAN NIMUBAH DOLO

Provider Business Mailing Address
First Line	:	9501 IDLEWOOD DR
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44144-3120
Country	:	US
Telephone Number	:	216-469-1335
Fax Number	:

Provider Business Practice Location Address
First Line	:	9501 IDLEWOOD DR
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44144-3120
Country	:	US
Telephone Number	:	216-469-1335
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/22/2025
Last Update Date	:	09/22/2025

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