Provider Demographics
NPI:1750044939
Name:ZEAITER, FAROUK M
Entity Type:Individual
Prefix:
First Name:FAROUK
Middle Name:M
Last Name:ZEAITER
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 1:2961 E SERENE AVE
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89074-6507
Mailing Address - Country:US
Mailing Address - Phone:702-948-4845
Mailing Address - Fax:
Practice Address - Street 1:2961 E SERENE AVE
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89074-6507
Practice Address - Country:US
Practice Address - Phone:702-948-4845
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-14
Last Update Date:2021-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant