1073592309 NPI number — AHN, ABDULLA & KRISHNAN, M.D., LTD

Table of content: (NPI 1073592309)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1073592309 NPI number — AHN, ABDULLA & KRISHNAN, M.D., LTD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
AHN, ABDULLA & KRISHNAN, M.D., LTD
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
SOUTHERN NEVADA NEONATAL SERVICES
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1073592309
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/28/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5586 S FORT APACHE RD
Provider Second Line Business Mailing Address:
SUITE 100
Provider Business Mailing Address City Name:
LAS VEGAS
Provider Business Mailing Address State Name:
NV
Provider Business Mailing Address Postal Code:
89148-7682
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
702-384-8099
Provider Business Mailing Address Fax Number:
702-384-3930

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5586 S FORT APACHE RD
Provider Second Line Business Practice Location Address:
SUITE 100
Provider Business Practice Location Address City Name:
LAS VEGAS
Provider Business Practice Location Address State Name:
NV
Provider Business Practice Location Address Postal Code:
89148-7682
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
702-384-8099
Provider Business Practice Location Address Fax Number:
702-384-3930
Provider Enumeration Date:
01/13/2006

Additional Information

Authorized Official

Authorized Official Last Name:
ABDULLA
Authorized Official First Name:
FAROOQ
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT/PHYSICIAN
Authorized Official Telephone Number:
702-384-8099

Provider Taxonomy Codes

  • Taxonomy code: 2080N0001X , registered in the state of NV ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2024 www.npivalidator.com