Provider Demographics
NPI:1033882360
Name:YOGEL, SHACHAR
Entity Type:Individual
Prefix:
First Name:SHACHAR
Middle Name:
Last Name:YOGEL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4773 LONGSHOT DR
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89122-5258
Mailing Address - Country:US
Mailing Address - Phone:702-372-8944
Mailing Address - Fax:
Practice Address - Street 1:4773 LONGSHOT DR
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89122-5258
Practice Address - Country:US
Practice Address - Phone:702-372-8944
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-02
Last Update Date:2021-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide