Organization
ARIZONA STATE UNIVERSITY
Active
Parent organization
ARIZONA STATE UNIVERSITY
Other names
NP Healthcare - Scottsdale
Organization subpart
Yes
Provider details
NPI number
Legal business name
ARIZONA STATE UNIVERSITY
Authorized official
DR. DENISE GIANNASCOLI LINK DNSC (ASSOCIATE DEAN)
(602) 496-0893
Entity
Organization
Contact information
Practice address
3225 N CIVIC CENTER PLZ, SUITE 10, SCOTTSDALE, AZ 85251-6919
(480) 884-1717
(480) 884-1711
Mailing address
500 N 3RD ST, SUITE 155, PHOENIX, AZ 85004-2135
(602) 496-0893
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
OTC 4747
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
03D0696288
CLIA ID NUMBER
AZ
05
—
132134
—
AZ
01
—
Z21383
MEDICARE PTAN
AZ
Enumeration date
10/30/2007
Last updated
08/05/2010
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