Provider Demographics
NPI:1437894763
Name:KISHKISH, HUSSAIN
Entity Type:Individual
Prefix:
First Name:HUSSAIN
Middle Name:
Last Name:KISHKISH
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 1:1430 HIALEAH DR APT C
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89119-6331
Mailing Address - Country:US
Mailing Address - Phone:702-534-9593
Mailing Address - Fax:
Practice Address - Street 1:4623 W DESERT INN RD
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89102-7116
Practice Address - Country:US
Practice Address - Phone:702-410-9629
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-02
Last Update Date:2022-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225C00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Counselor