Provider Demographics
NPI:1336261213
Name:NARAQI, LADAN (MD)
Entity type:Individual
Prefix:DR
First Name:LADAN
Middle Name:
Last Name:NARAQI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1300 S 10TH ST
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85034-4516
Mailing Address - Country:US
Mailing Address - Phone:602-257-4323
Mailing Address - Fax:602-257-4338
Practice Address - Street 1:1625 N 39TH AVE
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85009-2149
Practice Address - Country:US
Practice Address - Phone:602-257-4323
Practice Address - Fax:602-257-4338
Is Sole Proprietor?:No
Enumeration Date:2007-04-04
Last Update Date:2024-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ52967207V00000X
GA049494207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ812885Medicaid
AZ8HD913Medicare ID - Type UnspecifiedMEDICARE PART B - CHINLE
AZ8HD915Medicare ID - Type UnspecifiedMEDICARE PART B - TSAILE
AZ812885Medicaid
AZH96001Medicare UPIN