Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.
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NPI 1235781261

Individual provider · NPI 1235781261 Deactivated

This NPI was deactivated on September 3, 2026. The record is kept for reference and should not be used for billing or referrals.

NPI 1235781261 is listed in the national NPI registry.

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Record details

NPI number1235781261
Entity typeIndividual (Type 1)
NPI enumerated—
Last updated in NPPES—