| Kaniz F Islam | |
|
5209 W Siesta Way Laveen AZ 85339-7179 | |
| (602) 550-1008 | |
| Not Available |
| Full Name | Kaniz F Islam |
|---|---|
| Speciality | Nursing Care |
| Location | 5209 W Siesta Way, Laveen, Arizona |
| Authorized Official Name and Position | Kaniz Islam (NURSE PRACTITIONER) |
| Authorized Official Contact | 6025501008 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kaniz F Islam 5209 W Siesta Way Laveen AZ 85339-7179 Ph: (602) 550-1008 | Kaniz F Islam 5209 W Siesta Way Laveen AZ 85339-7179 Ph: (602) 550-1008 |
| NPI Number | 1073234639 |
|---|---|
| Provider Enumeration Date | 09/12/2022 |
| Last Update Date | 09/19/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073234639 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Secondary |
| 251J00000X | Nursing Care | (* (Not Available)) | Primary |
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