Healthcare Provider Details

I. General information

NPI: 1184074460
Provider Name (Legal Business Name): KANCHI NILESH BARFIWALA M.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/16/2016
Last Update Date: 06/16/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9300 VALLEY CHILDRENS PL
MADERA CA
93636-8761
US

IV. Provider business mailing address

5090 N PRIMITIVO WAY APARTMENT 203
FRESNO CA
93710-8233
US

V. Phone/Fax

Practice location:
  • Phone: 559-353-6700
  • Fax:
Mailing address:
  • Phone: 201-220-6142
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code170300000X
TaxonomyGenetic Counselor (M.S.)
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: