MEDICARE: BRIAN J CITRO MD

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	208600000X	Surgery Physician	11968	NV

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1922116771
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRIAN J CITRO MD

Provider Business Mailing Address
First Line	:	7375 PRAIRIE FALCON RD
Second Line	:	SUITE 150
City	:	LAS VEGAS
State	:	NV
Zip	:	89128-0810
Country	:	US
Telephone Number	:	702-648-9400
Fax Number	:	702-636-0249

Provider Business Practice Location Address
First Line	:	7375 PRAIRIE FALCON RD
Second Line	:	SUITE 150
City	:	LAS VEGAS
State	:	NV
Zip	:	89128-0810
Country	:	US
Telephone Number	:	702-648-9400
Fax Number	:	702-636-0249

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/29/2006
Last Update Date	:	02/11/2020

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Directions to “ BRIAN J CITRO MD” Practice Location

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