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General NPI Number Information
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NPI Number | 1841328077
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Entity Type | Individual
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Provider Name | SUPRIYA NAIR D.O.
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Gender | Female
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Dates
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Enumeration Date | 03/01/2007
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Last Update Date | 09/09/2016
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Provider Practice Location Address
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Address Line | 4835 E CACTUS RD SUITE 333
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City | SCOTTSDALE
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State | AZ
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Zip | 85254-4191
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Country | US
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Telephone | 602-795-9980
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Fax | 602-795-9984
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Provider Business Mailing Address
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Address Line | 4835 E CACTUS RD SUITE 333
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City | SCOTTSDALE
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State | AZ
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Zip | 85254-4191
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Country | US
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Telephone | 602-795-9980
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Fax | 602-795-9984
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 4526
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License Number State | AZ
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