MEDICARE: VENTANA HEALTH ASSOCIATES

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
1	2084P0800X	Psychiatry Physician	7031	NV

General Provider Information

NPI Number	:	1548503212
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VENTANA HEALTH ASSOCIATES

Provider Business Mailing Address
First Line	:	1885 VILLAGE CENTER CIR
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89134-6435
Country	:	US
Telephone Number	:	702-360-2800
Fax Number	:	702-360-2878

Provider Business Practice Location Address
First Line	:	1885 VILLAGE CENTER CIR
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89134-6435
Country	:	US
Telephone Number	:	702-360-2800
Fax Number	:	702-360-2878

Authorized Official
Title or Position	:	PRESIDENT
Name	:	SEAN DUFFY
Credential	:	M.D.
Telephone Number	:	702-360-2800

Provider Enumeration Date	:	04/01/2013
Last Update Date	:	04/01/2013

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