Healthcare Provider Details

I. General information

NPI: 1821236084
Provider Name (Legal Business Name): DEEPALI KASHYAP M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/27/2009
Last Update Date: 12/21/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1389 GALLERIA DR SUITE 220
HENDERSON NV
89014-6685
US

IV. Provider business mailing address

1389 GALLERIA DR SUITE 220
HENDERSON NV
89014-6685
US

V. Phone/Fax

Practice location:
  • Phone: 702-983-2010
  • Fax: 702-945-0322
Mailing address:
  • Phone: 702-983-2010
  • Fax: 702-945-0322

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VX0000X
TaxonomyObstetrics Physician
License Number13695
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: