Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.
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NPI 1619133386

Individual provider · NPI 1619133386 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 1619133386 is listed in the national NPI registry.

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Record details

NPI number1619133386
Entity typeIndividual (Type 1)
NPI enumerated—
Last updated in NPPES—