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NPI Code Detail

MEDICARE: MORA MIND

MEDICARE: MORA MIND
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12084P0800XPsychiatry Physician

General Provider Information

NPI Number : 1396509220
Entity Type Code : Organization
Provider Name (Legal Business Name) : MORA MIND
Provider Business Mailing Address
First Line : 6128 STRAND LOOP SE
Second Line :
City : ALBUQUERQUE
State : NM
Zip : 87106-9600
Country : US
Telephone Number : 702-935-4552
Fax Number :
Provider Business Practice Location Address
First Line : 3291 E WARM SPRINGS RD STE 300
Second Line :
City : LAS VEGAS
State : NV
Zip : 89120-3184
Country : US
Telephone Number : 702-935-4552
Fax Number :
Authorized Official
Title or Position : OWNER
Name : DR. GREGORY NIKOGOSYAN
Credential : DO
Telephone Number : 702-935-4552
Provider Enumeration Date : 02/12/2024
Last Update Date : 02/12/2024

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Directions to “MORA MIND ” Practice Location

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