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NPI Code Detail

MEDICARE: G PITTMAN

MEDICARE: G PITTMAN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103K00000XBehavior Analyst

General Provider Information

NPI Number : 1184009045
Entity Type Code : Individual
Provider Name (Legal Business Name) : G PITTMAN
Provider Business Mailing Address
First Line : 9404 SHELLFISH CT
Second Line :
City : LAS VEGAS
State : NV
Zip : 89117-0267
Country : US
Telephone Number : 702-981-1153
Fax Number : 702-974-4555
Provider Business Practice Location Address
First Line : 9404 SHELLFISH CT
Second Line :
City : LAS VEGAS
State : NV
Zip : 89117-0267
Country : US
Telephone Number : 702-981-1153
Fax Number : 702-974-4555
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/21/2015
Last Update Date : 07/21/2015

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Directions to “ G PITTMAN ” Practice Location

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