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General NPI Number Information
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NPI Number | 1245177377
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Entity Type | Organization
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Legal Business Name | NOURISH MEDICAL GROUP (KS) LLC
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Dates
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Enumeration Date | 04/29/2026
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Last Update Date | 04/29/2026
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Provider Practice Location Address
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Address Line | 1632 E 23RD AVE FL 1
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City | HUTCHINSON
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State | KS
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Zip | 67502-4705
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Country | US
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Telephone | 512-693-7045
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Fax |
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Provider Business Mailing Address
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Address Line | 257 PARK AVE S FL 9
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City | NEW YORK
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State | NY
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Zip | 10010-7304
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. AJAY HARYANI
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Credential |
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Telephone | 815-954-4829
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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