1952501249 NPI number — HANI NAZHA MD

Table of content: HANI NAZHA MD (NPI 1952501249)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1952501249 NPI number — HANI NAZHA MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
NAZHA
Provider First Name:
HANI
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

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:
1952501249
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/04/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 780125
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PHILADELPHIA
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
19178-0125
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
804-922-4844
Provider Business Mailing Address Fax Number:
804-327-3065

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
618 HOSPITAL RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
TAPPAHANNOCK
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
22560-5000
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
804-443-6282
Provider Business Practice Location Address Fax Number:
804-443-6051
Provider Enumeration Date:
07/24/2007

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: 207R00000X , with the licence number:  24598 , registered in the state of WV ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2084P0800X , with the licence number: 0101280107 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 3810022883 , issued by the state of ( WV ) . This identifiers is of the category "MEDICAID".
  • Identifier: 121653700 . This is a "Florida Medicaid Provider ID" identifier , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2024 www.npivalidator.com