Provider Demographics
NPI:1437385416
Name:DIABETES AND HEART HEALTH CONSULTANTS LLC
Entity Type:Organization
Organization Name:DIABETES AND HEART HEALTH CONSULTANTS LLC
Other - Org Name:DIABETES AND HEART HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIABETES PROGRAM MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:NIRALI
Authorized Official - Middle Name:
Authorized Official - Last Name:SONI
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD, RPH, CDE
Authorized Official - Phone:623-521-5867
Mailing Address - Street 1:5420 W MURIEL DR
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85308-5380
Mailing Address - Country:US
Mailing Address - Phone:623-521-5867
Mailing Address - Fax:602-441-3934
Practice Address - Street 1:20100 N 51ST AVE
Practice Address - Street 2:SUITE #F640
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85308-5125
Practice Address - Country:US
Practice Address - Phone:623-521-5867
Practice Address - Fax:602-441-3934
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-04
Last Update Date:2010-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
133NN1002X, 171W00000X
AZS0112051835N1003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1835N1003XPharmacy Service ProvidersPharmacistNutrition SupportGroup - Multi-Specialty
No133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, EducationGroup - Multi-Specialty
No171W00000XOther Service ProvidersContractorGroup - Multi-Specialty