Healthcare Provider Details

I. General information

NPI: 1225358070
Provider Name (Legal Business Name): AMY NICOLLE AFEK DVM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/03/2010
Last Update Date: 06/03/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1745 W. GLENDALE AVE.
PHOENIX AZ
85021
US

IV. Provider business mailing address

1745 W. GLENDALE AVE
PHOENIX AZ
85021
US

V. Phone/Fax

Practice location:
  • Phone: 602-943-3463
  • Fax: 602-861-0512
Mailing address:
  • Phone: 602-943-3463
  • Fax: 602-861-0512

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174M00000X
TaxonomyVeterinarian
License Number4069
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: