=====================================================
General NPI Number Information
=====================================================
NPI Number | 1306817572
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | NIRMALA ARYAL M.D.
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/27/2006
-----------------------------------------------------
Last Update Date | 07/06/2016
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 9150 W. INDIAN SCHOOL RD. SUITE 107
-----------------------------------------------------
City | PHOENIX
-----------------------------------------------------
State | AZ
-----------------------------------------------------
Zip | 85037
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 623-266-8002
-----------------------------------------------------
Fax | 623-266-8336
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 9150 W. INDIAN SCHOOL RD. SUITE 107
-----------------------------------------------------
City | PHOENIX
-----------------------------------------------------
State | AZ
-----------------------------------------------------
Zip | 85037
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 623-266-8002
-----------------------------------------------------
Fax | 623-266-8336
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 174400000X
-----------------------------------------------------
Taxonomy Name | Specialist
-----------------------------------------------------
License Number | 30309
-----------------------------------------------------
License Number State | AZ
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 2084N0400X
-----------------------------------------------------
Taxonomy Name | Neurology Physician
-----------------------------------------------------
License Number | 30309
-----------------------------------------------------
License Number State | AZ
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 2084P0800X
-----------------------------------------------------
Taxonomy Name | Psychiatry Physician
-----------------------------------------------------
License Number | 30309
-----------------------------------------------------
License Number State | AZ
-----------------------------------------------------