Provider Demographics
NPI:1285894139
Name:BAGDASARIAN, NAIRA (RDMS, RVT, RDCS)
Entity type:Individual
Prefix:
First Name:NAIRA
Middle Name:
Last Name:BAGDASARIAN
Suffix:
Gender:F
Credentials:RDMS, RVT, RDCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6380 NARROW ISTHMUS AVE
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89139-6411
Mailing Address - Country:US
Mailing Address - Phone:702-460-1941
Mailing Address - Fax:702-252-5044
Practice Address - Street 1:6380 NARROW ISTHMUS AVE
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89139-6411
Practice Address - Country:US
Practice Address - Phone:702-460-1941
Practice Address - Fax:702-252-5044
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-13
Last Update Date:2008-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV2000091-3202471S1302X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2471S1302XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistSonography
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV2000091-320OtherLICENSE #