1144429887 NPI number — MRS. DILAFROZE AYESHA THANADAR R.D.

Table of content: MRS. DILAFROZE AYESHA THANADAR R.D. (NPI 1144429887)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1144429887 NPI number — MRS. DILAFROZE AYESHA THANADAR R.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
THANADAR
Provider First Name:
DILAFROZE
Provider Middle Name:
AYESHA
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
R.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
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:
1144429887
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/12/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
301 GOODE WAY
Provider Second Line Business Mailing Address:
SUITE 201
Provider Business Mailing Address City Name:
PORTSMOUTH
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
23704-2266
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
757-397-0709
Provider Business Mailing Address Fax Number:
757-483-0726

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
301 GOODE WAY
Provider Second Line Business Practice Location Address:
SUITE 201
Provider Business Practice Location Address City Name:
PORTSMOUTH
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
23704-2266
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
757-397-0709
Provider Business Practice Location Address Fax Number:
757-483-0726
Provider Enumeration Date:
07/12/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 133V00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





Copyright © 2007-2025 www.npivalidator.com