MEDICARE: EMESE HAJDAR

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant		NV

General Provider Information

NPI Number	:	1194693739
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EMESE HAJDAR

Provider Business Mailing Address
First Line	:	2603 S DURANGO DR APT 202
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89117-2615
Country	:	US
Telephone Number	:	702-325-8235
Fax Number	:

Provider Business Practice Location Address
First Line	:	2480 PROFESSIONAL CT # 110
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89128-0835
Country	:	US
Telephone Number	:	702-868-9100
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/27/2025
Last Update Date	:	10/27/2025

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Directions to “ EMESE HAJDAR ” Practice Location

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