Healthcare Provider Details

I. General information

NPI: 1164096269
Provider Name (Legal Business Name): NILANJAN HALDAR MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/14/2021
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

350 W THOMAS RD ATTN: BNI RADIATION ONCOLOGY
PHOENIX AZ
85013
US

IV. Provider business mailing address

240 W THOMAS RD STE 301
PHOENIX AZ
85013-4407
US

V. Phone/Fax

Practice location:
  • Phone: 602-406-6761
  • Fax: 602-406-5515
Mailing address:
  • Phone: 602-406-7765
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMT222932
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License Number81242
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: