Basic Information
| Provider Information | |||||||||
| NPI: | 1326223421 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MOHARI | ||||||||
| FirstName: | NIVEDITA | ||||||||
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| Credential: | M.B.B.S. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1417 S CLIFF AVE STE 201 | ||||||||
| Address2: | |||||||||
| City: | SIOUX FALLS | ||||||||
| State: | SD | ||||||||
| PostalCode: | 571051009 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6053223666 | ||||||||
| FaxNumber: | 6053223665 | ||||||||
| Practice Location | |||||||||
| Address1: | 1417 S CLIFF AVE STE 201 | ||||||||
| Address2: | |||||||||
| City: | SIOUX FALLS | ||||||||
| State: | SD | ||||||||
| PostalCode: | 571051009 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6053223666 | ||||||||
| FaxNumber: | 6053223665 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/08/2008 | ||||||||
| LastUpdateDate: | 03/17/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 03/17/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2080P0203X | 12268 | SD | Y | Allopathic & Osteopathic Physicians | Pediatrics | Pediatric Critical Care Medicine |
No ID Information.