OrganizationActive
Idaho Memory & Aging Center PLLC
NPI 1730528548 · Geriatric Psychiatry Physician · Boise, ID
Provider details
- NPI number
- 1730528548
- Entity type
- Organization
- Primary specialty
- Geriatric Psychiatry PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Abhilash Desai, Medical Director(617) 922-4957
- License
- M-12079 (ID)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Practice location
413 N Allumbaugh St
Ste# 101
Boise, ID 83704-9212
Phone: (617) 922-4957
Approximate (ZIP-level) locationGet directions
Mailing address
413 N Allumbaugh St
Boise, ID 83704-9212
Registry dates
- Enumerated
- 2013-06-14
- Last updated
- 2013-07-19
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.