Provider Demographics
NPI:1467714477
Name:WAZIRI, NADYA (LAC)
Entity Type:Individual
Prefix:
First Name:NADYA
Middle Name:
Last Name:WAZIRI
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1050 PEARL ST APT 104
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80203-3298
Mailing Address - Country:US
Mailing Address - Phone:303-817-9727
Mailing Address - Fax:
Practice Address - Street 1:500 ELDORADO BLVD
Practice Address - Street 2:
Practice Address - City:BROOMFIELD
Practice Address - State:CO
Practice Address - Zip Code:80021-3408
Practice Address - Country:US
Practice Address - Phone:303-817-9727
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-14
Last Update Date:2012-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1561171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist