Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2084N0400X | Neurologist | 46623 | AZ |
N | 2084N0600X | Clinical Neurophysiologist | 46623 | AZ |
NPI | 1285833681 |
---|---|
Provider Name | Dr. Jay Kumar Fishleder Varma |
First Address | Phoenix, AZ 85013-4407 |
Second Address | Phoenix, AZ 85013-4407 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/07/2007 |
Last Update Date | 17/09/2018 |