Basic Information
Provider Information
NPI: 1275728933
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: THAWANI
FirstName: NITIKA
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 3030 N CENTRAL AVE STE 1001
Address2:  
City: PHOENIX
State: AZ
PostalCode: 850122716
CountryCode: US
TelephoneNumber: 6024064786
FaxNumber: 9136364358
Practice Location
Address1: 625 N 6TH ST
Address2:  
City: PHOENIX
State: AZ
PostalCode: 85004
CountryCode: US
TelephoneNumber: 6024068222
FaxNumber: 6024067811
Other Information
ProviderEnumerationDate: 09/06/2007
LastUpdateDate: 07/18/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2085R0001XN7591TXN Allopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
2085R0001X51103AZY Allopathic & Osteopathic PhysiciansRadiologyRadiation Oncology

No ID Information.


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