Provider Demographics
NPI:1710285044
Name:BILALYAN, HERMINE
Entity Type:Individual
Prefix:MS
First Name:HERMINE
Middle Name:
Last Name:BILALYAN
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 1:7835 S RAINBOW BLVD
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89139-6455
Mailing Address - Country:US
Mailing Address - Phone:702-292-1995
Mailing Address - Fax:
Practice Address - Street 1:7235 ADOBE FALLS CT
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89113-3088
Practice Address - Country:US
Practice Address - Phone:702-292-1995
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-10
Last Update Date:2011-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVNV20111126584251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health