Provider Demographics
NPI:1609309947
Name:AXHIJAJ, LULZIM
Entity Type:Individual
Prefix:
First Name:LULZIM
Middle Name:
Last Name:AXHIJAJ
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 1:1562 VIKING BLVD NE
Mailing Address - Street 2:
Mailing Address - City:EAST BETHEL
Mailing Address - State:MN
Mailing Address - Zip Code:55011-9402
Mailing Address - Country:US
Mailing Address - Phone:763-450-5561
Mailing Address - Fax:
Practice Address - Street 1:1562 VIKING BLVD NE
Practice Address - Street 2:
Practice Address - City:EAST BETHEL
Practice Address - State:MN
Practice Address - Zip Code:55011-9402
Practice Address - Country:US
Practice Address - Phone:763-450-5561
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-04
Last Update Date:2017-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)