Neutrino LLC

Primary specialty

Plastic Surgery PhysicianTaxonomy code 208200000X

Legal business name

NEUTRINO LLC

Practice address

10910 N Tatum Blvd Ste B100
Phoenix, AZ 85028-3080

Phone

(631) 827-8159

NPI assigned

Jan 23, 2019

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mathew James

Title

Patient Accounts

Phone

(631) 827-8159

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1548201600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1548201600000",
    "number": "1083178115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10910 N TATUM BLVD STE B100",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850283080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10910 N TATUM BLVD STE B100",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850283080",
            "telephone_number": "631-827-8159"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEUTRINO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-01-23",
        "last_updated": "2019-01-23",
        "status": "A",
        "authorized_official_last_name": "JAMES",
        "authorized_official_first_name": "MATHEW",
        "authorized_official_title_or_position": "PATIENT ACCOUNTS",
        "authorized_official_telephone_number": "631-827-8159"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Plastic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Plastic Surgery Physician in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Plastic Surgery Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.