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

NPI 1124286026

Individual provider · NPI 1124286026 Deactivated

This NPI was deactivated on September 24, 2026. The record is kept for reference and should not be used for billing or referrals.

NPI 1124286026 is listed in the national NPI registry.

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Record details

NPI number1124286026
Entity typeIndividual (Type 1)
NPI enumerated—
Last updated in NPPES—