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Organization

AZ NICU GROUP PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. LATHA KUMARASWAMY (CEO)
(520) 604-3148
Entity
Organization

Contact information

Practice address
1301 S CRISMON RD, MESA, AZ 85209-3767
(480) 906-7449
Mailing address
862 E NARANJA DR, ORO VALLEY, AZ 85737-8642

Taxonomy

Speciality
Code
Description
License number
State
2080N0001X
Neonatal-Perinatal Medicine Physician
Primary

Other

Enumeration date
01/17/2023
Last updated
01/17/2023
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