Provider Demographics
NPI:1558958843
Name:ZIYAD, NADIYAH FAJRI (LMT)
Entity Type:Individual
Prefix:
First Name:NADIYAH
Middle Name:FAJRI
Last Name:ZIYAD
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1323 N GILPIN ST APT 602
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80218-2538
Mailing Address - Country:US
Mailing Address - Phone:720-231-8745
Mailing Address - Fax:
Practice Address - Street 1:300 JOSEPHINE ST STE 230
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80206-4218
Practice Address - Country:US
Practice Address - Phone:720-231-8745
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-21
Last Update Date:2020-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COMT0018508225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty