Provider Demographics
NPI:1356137103
Name:MALKHASYAN, HASMIK (MEDICAL ASSISTANT)
Entity type:Individual
Prefix:
First Name:HASMIK
Middle Name:
Last Name:MALKHASYAN
Suffix:
Gender:
Credentials:MEDICAL ASSISTANT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:775 CONNEX CT
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89178-1272
Mailing Address - Country:US
Mailing Address - Phone:818-926-7775
Mailing Address - Fax:
Practice Address - Street 1:4225 S EASTERN AVE
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89119-5486
Practice Address - Country:US
Practice Address - Phone:702-201-1956
Practice Address - Fax:702-552-0302
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-17
Last Update Date:2025-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
374700000X
NV51882-AL-0246RP1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomy
No374700000XNursing Service Related ProvidersTechnician