Provider Demographics
NPI:1619766425
Name:DALAL, KHUSHALI (PA-C)
Entity type:Individual
Prefix:
First Name:KHUSHALI
Middle Name:
Last Name:DALAL
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18230 WILLIAMSBURG OVAL
Mailing Address - Street 2:
Mailing Address - City:STRONGSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44136-7090
Mailing Address - Country:US
Mailing Address - Phone:440-915-0369
Mailing Address - Fax:
Practice Address - Street 1:18230 WILLIAMSBURG OVAL
Practice Address - Street 2:
Practice Address - City:STRONGSVILLE
Practice Address - State:OH
Practice Address - Zip Code:44136-7090
Practice Address - Country:US
Practice Address - Phone:440-915-0369
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-06
Last Update Date:2025-05-06
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant