Provider Demographics
NPI:1104329416
Name:TCHALAKIAN, NIGOL
Entity type:Individual
Prefix:MR
First Name:NIGOL
Middle Name:
Last Name:TCHALAKIAN
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 1:2609 SILVERTON DR
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89134-8835
Mailing Address - Country:US
Mailing Address - Phone:626-979-4230
Mailing Address - Fax:
Practice Address - Street 1:2851 S VALLEY VIEW BLVD UNIT 1113
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89102-0162
Practice Address - Country:US
Practice Address - Phone:626-979-4230
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-13
Last Update Date:2018-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant