Provider Demographics
NPI: | 1194506378 |
---|---|
Name: | MISHERFI, ANDREW |
Entity type: | Individual |
Prefix: | |
First Name: | ANDREW |
Middle Name: | |
Last Name: | MISHERFI |
Suffix: | |
Gender: | |
Credentials: | |
Other - Prefix: | |
Other - First Name: | |
Other - Middle Name: | |
Other - Last Name: | |
Other - Suffix: | |
Other - Last Name Type: | |
Other - Credentials: | |
Mailing Address - Street 1: | 3340 TOPAZ ST STE 100 |
Mailing Address - Street 2: | |
Mailing Address - City: | LAS VEGAS |
Mailing Address - State: | NV |
Mailing Address - Zip Code: | 89121-3906 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 702-971-7531 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 3340 TOPAZ ST STE 100 |
Practice Address - Street 2: | |
Practice Address - City: | LAS VEGAS |
Practice Address - State: | NV |
Practice Address - Zip Code: | 89121-3906 |
Practice Address - Country: | US |
Practice Address - Phone: | 702-971-7531 |
Practice Address - Fax: | |
Is Sole Proprietor?: | No |
Enumeration Date: | 2023-10-12 |
Last Update Date: | 2025-03-13 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 3747P1801X | Nursing Service Related Providers | Technician | Personal Care Attendant |
No | 172V00000X | Other Service Providers | Community Health Worker | |
No | 372500000X | Nursing Service Related Providers | Chore Provider | |
No | 372600000X | Nursing Service Related Providers | Adult Companion | |
No | 3747A0650X | Nursing Service Related Providers | Technician | Attendant Care Provider |
No | 376J00000X | Nursing Service Related Providers | Homemaker |