1356633424 NPI number — FRADKIN SURGICAL SERVICES PLLC

Table of content: DR. HANNAH BELT PT, DPT (NPI 1457234874)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1356633424 NPI number — FRADKIN SURGICAL SERVICES PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
FRADKIN SURGICAL SERVICES PLLC
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:
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:
1356633424
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/14/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
9811 W CHARLESTON BLVD STE 2-366
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LAS VEGAS
Provider Business Mailing Address State Name:
NV
Provider Business Mailing Address Postal Code:
89117-7528
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
702-538-9284
Provider Business Mailing Address Fax Number:
702-989-8444

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
9811 W CHARLESTON BLVD STE 2-366
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LAS VEGAS
Provider Business Practice Location Address State Name:
NV
Provider Business Practice Location Address Postal Code:
89117-7528
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
702-538-9284
Provider Business Practice Location Address Fax Number:
702-989-8444
Provider Enumeration Date:
05/09/2011

Additional Information

Authorized Official

Authorized Official Last Name:
FRADKIN
Authorized Official First Name:
KEVIN
Authorized Official Middle Name:
Authorized Official Title or Position:
MANAGING MEMBER
Authorized Official Telephone Number:
702-538-9284

Provider Taxonomy Codes

  • Taxonomy code: 208600000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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