Basic Information
| Provider Information | |||||||||
| NPI: | 1669625851 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | OVANESSOFF | ||||||||
| FirstName: | GARINEH | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 500 W. THOMAS RD. | ||||||||
| Address2: | SUITE 900B | ||||||||
| City: | PHOENIX | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 850134272 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6024062323 | ||||||||
| FaxNumber: | 6024064272 | ||||||||
| Practice Location | |||||||||
| Address1: | 500 W THOMAS RD STE 900B | ||||||||
| Address2: | |||||||||
| City: | PHOENIX | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 850134224 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6024062323 | ||||||||
| FaxNumber: | 6024063978 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/31/2008 | ||||||||
| LastUpdateDate: | 05/04/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 05/04/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RE0101X | 48635 | AZ | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Endocrinology, Diabetes & Metabolism |
No ID Information.