Basic Information
| Provider Information | |||||||||
| NPI: | 1336707017 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ARIZONA CENTER FOR ADVANCED LIPIDOLOGY PLLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3925 E FORT LOWELL RD STE 105 | ||||||||
| Address2: | |||||||||
| City: | TUCSON | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 857121053 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5202290085 | ||||||||
| FaxNumber: | 5202290086 | ||||||||
| Practice Location | |||||||||
| Address1: | 3925 E FORT LOWELL RD STE 105 | ||||||||
| Address2: | |||||||||
| City: | TUCSON | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 857121053 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5202290085 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/29/2019 | ||||||||
| LastUpdateDate: | 06/28/2022 | ||||||||
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| AuthorizedOfficialLastName: | CIFFONE | ||||||||
| AuthorizedOfficialFirstName: | NICOLE | ||||||||
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| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 5202704264 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | NP | ||||||||
| NPICertificationDate: | 06/28/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 364SA2200X | Y | 193400000X SINGLE SPECIALTY GROUP | Physician Assistants & Advanced Practice Nursing Providers | Clinical Nurse Specialist | Adult Health |
No ID Information.