Healthcare Provider Details
I. General information
NPI: 1285867424
Provider Name (Legal Business Name): AIDA MUSIC MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 09/03/2009
Last Update Date: 04/16/2019
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2929 E THOMAS RD
PHOENIX AZ
85016-8034
US
IV. Provider business mailing address
4324 E. REDFIELD RD.
PHOENIX AZ
85032
US
V. Phone/Fax
- Phone: 602-470-5000
- Fax:
- Phone: 602-405-1623
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2084P0804X |
| Taxonomy | Child & Adolescent Psychiatry Physician |
| License Number | 43595 |
| License Number State | AZ |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2084P0800X |
| Taxonomy | Psychiatry Physician |
| License Number | 43595 |
| License Number State | AZ |
VII. Legacy identifiers
For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: