Provider Demographics
NPI:1982945010
Name:HEART TO SOLE DIAGNOSTICS
Entity type:Organization
Organization Name:HEART TO SOLE DIAGNOSTICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:NINEF
Authorized Official - Middle Name:
Authorized Official - Last Name:AGHAKHAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:414-935-4545
Mailing Address - Street 1:7635 WEST BLUEMOUND ROAD, SUITE 1C
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53213-3500
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7635 WEST BLUEMOUND ROAD, SUITE 1C
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53213-3500
Practice Address - Country:US
Practice Address - Phone:414-935-4545
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-14
Last Update Date:2013-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes293D00000XLaboratoriesPhysiological Laboratory