Basic Information
Provider Information
NPI: 1174501894
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MACHHI
FirstName: JINOBYA
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 7111 FAIRWAY DR
Address2: SUITE 400
City: PALM BEACH GARDENS
State: FL
PostalCode: 334184204
CountryCode: US
TelephoneNumber: 5617127335
FaxNumber: 5617127349
Practice Location
Address1: 11020 W PLANK CT
Address2: SUITE 100
City: WAUWATOSA
State: WI
PostalCode: 532263279
CountryCode: US
TelephoneNumber: 4144768122
FaxNumber: 4144762975
Other Information
ProviderEnumerationDate: 01/03/2006
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207ZP0102X39413WIY Allopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology

No ID Information.


Home