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General NPI Number Information
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NPI Number | 1003250069
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Entity Type | Individual
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Provider Name | NIZHONI W DENIPAH M.D.
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Gender | Female
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Dates
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Enumeration Date | 04/22/2013
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Last Update Date | 05/28/2025
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Provider Practice Location Address
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Address Line | 4200 BECKNER RD
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City | SANTA FE
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State | NM
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Zip | 87507-3774
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Country | US
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Telephone | 505-477-2200
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Fax | 505-782-1902
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Provider Business Mailing Address
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Address Line | 150 WASHINGTON AVE STE 201
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City | SANTA FE
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State | NM
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Zip | 87501-2038
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Country | US
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Telephone | 505-477-2200
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Fax | 505-782-1902
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | MD2018-0901
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License Number State | NM
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