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Organization

CASELLI AVENUE PROFESSIONALS

Active
Other names
North Mountain Cardio Health & Fitness
Organization subpart
No

Provider details

NPI number
Authorized official
JOHN SUTHERLAND M.D. (CEO)
(602) 714-6783
Entity
Organization

Contact information

Practice address
9812 N 7TH ST, 9812 N 7TH STREET SUITE 7, PHOENIX, AZ 85020-1763
(602) 714-6783
(602) 325-0125
Mailing address
9812 N 7TH ST, 9812 N 7TH STREET SUITE 7, PHOENIX, AZ 85020-1763
(602) 714-6783
(602) 325-0125

Taxonomy

Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
27801
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
060049547
RAILROAD MEDICARE
AZ
05
445470
AZ
01
WCSKQ
SUN HEALTH GROUP
AZ
Enumeration date
08/31/2015
Last updated
08/31/2015
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