NPI Code Detail JSON Logo

1033469887 NPI number — POONEH MUSSMAN PA

NPI Number: 1033469887
Health Care Provider/Practitioner: POONEH MUSSMAN PA

Information about “1033469887” NPI (POONEH MUSSMAN PA) exists in 1033469887 in HTML format HTML  |  1033469887 in plain Text format TXT  |  1033469887 in PDF (Portable Document Format) PDF  |  1033469887 in an XML format XML  formats.

NPI Number : 1033469887 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1033469887",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "MUSSMAN",
    "FirstName": "POONEH",
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "PA",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "9250 N 3RD ST",
    "SecondLineMailingAddress": "SUITE 1003",
    "MailingAddressCityName": "PHOENIX",
    "MailingAddressStateName": "AZ",
    "MailingAddressPostalCode": "85020-2437",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "602-331-7811",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "9250 N 3RD ST",
    "SecondLinePracticeLocationAddress": "SUITE 1003",
    "PracticeLocationAddressCityName": "PHOENIX",
    "PracticeLocationAddressStateName": "AZ",
    "PracticeLocationAddressPostalCode": "85020-2437",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "602-331-7811",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "09/19/2012",
    "LastUpdateDate": "04/08/2016",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "363A00000X",
        "TaxonomyName": "Physician Assistant",
        "LicenseNumber": "5601006383",
        "LicenseNumberStateCode": "MI",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

Copyright © 2007-2026 Data Labs Health. All rights reserved.