Provider Demographics
NPI:1003250069
Name:DENIPAH, NIZHONI W (MD)
Entity Type:Individual
Prefix:DR
First Name:NIZHONI
Middle Name:W
Last Name:DENIPAH
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Gender:F
Credentials:MD
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Mailing Address - Street 1:933 BRADBURY DR SE
Mailing Address - Street 2:SUITE 2222
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87106-4374
Mailing Address - Country:US
Mailing Address - Phone:505-272-3120
Mailing Address - Fax:505-272-8060
Practice Address - Street 1:1 UNIVERSITY OF NM
Practice Address - Street 2:MSC10 5610
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87131-0001
Practice Address - Country:US
Practice Address - Phone:505-272-2336
Practice Address - Fax:505-925-4310
Is Sole Proprietor?:No
Enumeration Date:2013-04-22
Last Update Date:2018-11-13
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Provider Licenses
StateLicense IDTaxonomies
390200000X
NMMD2018-0901207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program