Provider Demographics
NPI:1689157166
Name:HEALTHY LIVING DIABETES AND ENDOCRINOLOGY PLC
Entity Type:Organization
Organization Name:HEALTHY LIVING DIABETES AND ENDOCRINOLOGY PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER/MANAGING EMPLOYEE
Authorized Official - Prefix:DR
Authorized Official - First Name:NAGA NALINI
Authorized Official - Middle Name:
Authorized Official - Last Name:TIRUMALASETTY
Authorized Official - Suffix:
Authorized Official - Credentials:MD, ECNU, FACE
Authorized Official - Phone:480-269-6448
Mailing Address - Street 1:908 W CHANDLER BLVD B-4
Mailing Address - Street 2:BUILDING B, SUITE 4
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85225-2548
Mailing Address - Country:US
Mailing Address - Phone:480-269-6448
Mailing Address - Fax:779-204-2331
Practice Address - Street 1:908 W CHANDLER BLVD B-4
Practice Address - Street 2:BUILDING B, SUITE 4
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85225-2548
Practice Address - Country:US
Practice Address - Phone:480-269-6448
Practice Address - Fax:779-204-2331
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-11
Last Update Date:2022-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Single Specialty