Provider Demographics
NPI:1942958228
Name:NAYFEH, IVAN AMEIN (MS, CEP, CCRP, PRC)
Entity Type:Individual
Prefix:MR
First Name:IVAN
Middle Name:AMEIN
Last Name:NAYFEH
Suffix:
Gender:M
Credentials:MS, CEP, CCRP, PRC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18843 AGIN CT
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78258-4481
Mailing Address - Country:US
Mailing Address - Phone:210-667-0363
Mailing Address - Fax:
Practice Address - Street 1:18843 AGIN CT
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78258-4481
Practice Address - Country:US
Practice Address - Phone:210-667-0363
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-15
Last Update Date:2022-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1049243224Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Y00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersClinical Exercise Physiologist