Provider Demographics
NPI:1871008128
Name:BARSEGHYAN, KHOREN
Entity Type:Individual
Prefix:
First Name:KHOREN
Middle Name:
Last Name:BARSEGHYAN
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 1:3075 GREENBRIAR DR
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89121-2405
Mailing Address - Country:US
Mailing Address - Phone:702-561-7407
Mailing Address - Fax:
Practice Address - Street 1:3075 GREENBRIAR DR
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89121-2405
Practice Address - Country:US
Practice Address - Phone:702-561-7407
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-12-08
Last Update Date:2017-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care