Healthcare Provider Details

I. General information

NPI: 1114014222
Provider Name (Legal Business Name): JOSEPH NANIA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/09/2006
Last Update Date: 07/31/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1919 E THOMAS RD INFECTION PREVENTION AND CONTROL
PHOENIX AZ
85016-7710
US

IV. Provider business mailing address

PO BOX 8022
CHANDLER AZ
85246-8022
US

V. Phone/Fax

Practice location:
  • Phone: 602-667-4438
  • Fax:
Mailing address:
  • Phone: 480-636-1149
  • Fax: 480-452-0998

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0208X
TaxonomyPediatric Infectious Diseases Physician
License Number36954
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: