Arizona Skin and Laser Therapy Institue, LTD
Organization Active NPI Radiation Oncology Physician · Phoenix, AZ
NPI 1083066450 · NPPES record last updated Jul 8, 2016
Key facts
- NPI
- 1083066450
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Radiation Oncology Physician 2085R0001X
- Legal business name
- ARIZONA SKIN AND LASER THERAPY INSTITUE, LTD
- Practice address
- 16620 N 40TH St
Suite C-3
Phoenix, AZ 85032-3348 - Phone
- (602) 396-0851
- Fax
- (602) 841-0611
- NPI assigned
- Jul 8, 2016
- Organization subpart
- No
Authorized official
- Name
- Neil P Superfon, D.O.
- Title
- Physician
- Phone
- (602) 277-1449
Other NPIs on the same Medicare enrollment 9
Practitioners 1
-
Arundathi P. Narayanappa, P.A.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AZ
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040209000424 | AZ | Part B Supplier - Clinic/Group Practice | 6204720626 |
Receives reassigned benefits from 17 practitioners 9 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Apache Junction, AZ; Coolidge, AZ; Gilbert, AZ; Mesa, AZ; Phoenix, AZ; Quartzsite, AZ; Scottsdale, AZ; Show Low, AZ |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Procedural Dermatology Physician |
207NS0135X | |||
| Radiation Oncology Physician |
2085R0001X | Yes |
Addresses
Primary practice location
16620 N 40TH St
Suite C-3
Phoenix, AZ 85032-3348
Mailing address
2224 W. Northern Ave.
Suite D-300
Phoenix, AZ 85021-5099
Phone (602) 277-1449
Other providers in Phoenix, AZ
- Arizona Retina and Vitreous Consultants LLC
- Arizona S Advanced Wound Care LLC
- Arizona Senior Life LLC
- Arizona Serenity Home Care LLC
- Arizona Sinus and ENT Associates PC
- Arizona Skin and Laser Therapy Institute, LLC
- Arizona Skin and Laser Therapy Institute, LTD
- Arizona Skin Specialists Dermatology, LLC
- Arizona Skin Specialists PLLC
- Arizona Sleep Centers
All providers in Phoenix, AZ · Radiation Oncology Physician in Arizona
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.