Provider Demographics
NPI:1679017347
Name:NAQVI, NIDA
Entity Type:Individual
Prefix:
First Name:NIDA
Middle Name:
Last Name:NAQVI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:H# 81/A ST # 06 DHOKE MISTRIAN TENCH BHATTA
Mailing Address - Street 2:
Mailing Address - City:RAWALPINDI
Mailing Address - State:PUNJAB
Mailing Address - Zip Code:46000
Mailing Address - Country:PK
Mailing Address - Phone:09251-551-9867
Mailing Address - Fax:0012-333-3333
Practice Address - Street 1:1006 N SPENCER LN
Practice Address - Street 2:BLOOMFIELD NEW MEXICO
Practice Address - City:BLOOMFIELD
Practice Address - State:NM
Practice Address - Zip Code:87413-6411
Practice Address - Country:US
Practice Address - Phone:505-801-2017
Practice Address - Fax:123-456-6788
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-14
Last Update Date:2016-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician