Provider Demographics
NPI:1417652041
Name:PAIRADOX PLUS, LLC
Entity type:Organization
Organization Name:PAIRADOX PLUS, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:DELATTE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:646-468-6484
Mailing Address - Street 1:3303 S LINDSAY RD STE 104
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85297-1504
Mailing Address - Country:US
Mailing Address - Phone:480-863-6113
Mailing Address - Fax:480-863-6443
Practice Address - Street 1:3303 S LINDSAY RD STE 104
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85297-1504
Practice Address - Country:US
Practice Address - Phone:480-863-6113
Practice Address - Fax:480-863-6443
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-03
Last Update Date:2024-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty