Provider Demographics
NPI:1942824941
Name:DEEPA HASIJA MD PLLC
Entity Type:Organization
Organization Name:DEEPA HASIJA MD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DEEPA
Authorized Official - Middle Name:
Authorized Official - Last Name:HASIJA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:702-780-6200
Mailing Address - Street 1:4000 S EASTERN AVE STE 125
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89119-0814
Mailing Address - Country:US
Mailing Address - Phone:702-780-6200
Mailing Address - Fax:888-433-5792
Practice Address - Street 1:4000 S EASTERN AVE STE 125
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89119-0814
Practice Address - Country:US
Practice Address - Phone:702-780-6200
Practice Address - Fax:888-433-5792
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-04
Last Update Date:2020-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health