Provider Demographics
NPI:1518195247
Name:KEROLES, SADAF (PA-C)
Entity Type:Individual
Prefix:
First Name:SADAF
Middle Name:
Last Name:KEROLES
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:SADAF
Other - Middle Name:
Other - Last Name:SHARAFI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:9030 W SAHARA AVE
Mailing Address - Street 2:#249
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89117-5744
Mailing Address - Country:US
Mailing Address - Phone:702-921-6829
Mailing Address - Fax:702-974-1606
Practice Address - Street 1:7251 W LAKE MEAD BLVD STE 300
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89128-8380
Practice Address - Country:US
Practice Address - Phone:702-629-6992
Practice Address - Fax:702-974-1606
Is Sole Proprietor?:No
Enumeration Date:2009-07-01
Last Update Date:2021-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVPA1174363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical