Provider Demographics
NPI:1912518044
Name:NSOBI PLLC
Entity type:Organization
Organization Name:NSOBI PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MEMEBER
Authorized Official - Prefix:
Authorized Official - First Name:ALEX
Authorized Official - Middle Name:
Authorized Official - Last Name:ONOFREI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:480-807-3554
Mailing Address - Street 1:1652 N CHANNING
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85207-3196
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6130 E BROWN RD STE 101
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85205-4960
Practice Address - Country:US
Practice Address - Phone:480-807-3554
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-12
Last Update Date:2020-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QS0010XAllopathic & Osteopathic PhysiciansFamily MedicineSports MedicineGroup - Single Specialty