Provider Demographics
NPI:1194693739
Name:HAJDAR, EMESE
Entity type:Individual
Prefix:
First Name:EMESE
Middle Name:
Last Name:HAJDAR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2603 S DURANGO DR APT 202
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89117-2615
Mailing Address - Country:US
Mailing Address - Phone:702-325-8235
Mailing Address - Fax:
Practice Address - Street 1:2480 PROFESSIONAL CT # 110
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89128-0835
Practice Address - Country:US
Practice Address - Phone:702-868-9100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-10-27
Last Update Date:2025-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant