Provider Demographics
NPI:1801596234
Name:SEZIRAHIGA, GAD
Entity type:Individual
Prefix:
First Name:GAD
Middle Name:
Last Name:SEZIRAHIGA
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 1:5312 E TAYLOR ST
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85008-6713
Mailing Address - Country:US
Mailing Address - Phone:602-632-8943
Mailing Address - Fax:
Practice Address - Street 1:5312 E TAYLOR ST
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85008-6713
Practice Address - Country:US
Practice Address - Phone:602-632-8943
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-06
Last Update Date:2023-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health