Provider Demographics
NPI:1225040231
Name:NORTHERN UTAH NEPHROLOGY, LLC
Entity Type:Organization
Organization Name:NORTHERN UTAH NEPHROLOGY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:HARRY
Authorized Official - Middle Name:O
Authorized Official - Last Name:SENEKJIAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:801-479-1117
Mailing Address - Street 1:425 E 5350 S
Mailing Address - Street 2:SUITE 320
Mailing Address - City:OGDEN
Mailing Address - State:UT
Mailing Address - Zip Code:84405-6946
Mailing Address - Country:US
Mailing Address - Phone:801-479-1117
Mailing Address - Fax:801-476-1621
Practice Address - Street 1:425 E 5350 S
Practice Address - Street 2:SUITE 320
Practice Address - City:OGDEN
Practice Address - State:UT
Practice Address - Zip Code:84405-6946
Practice Address - Country:US
Practice Address - Phone:801-479-1117
Practice Address - Fax:801-476-1621
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Single Specialty