Healthcare Provider Details

I. General information

NPI: 1881634178
Provider Name (Legal Business Name): DR. NADIA HALIMI
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 06/07/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CMR 470 HANAU DENTAL CLINIC
APO AE NY
09165
US

IV. Provider business mailing address

CMR 470 HANAU DENTAL CLINIC
APO AE NY
09165
US

V. Phone/Fax

Practice location:
  • Phone: 952-294-3565
  • Fax:
Mailing address:
  • Phone: 952-294-3565
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberD11617
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: