Healthcare Provider Details

I. General information

NPI: 1295967784
Provider Name (Legal Business Name): ROSNER P. LUSS MD LTD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/17/2009
Last Update Date: 06/11/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1621 E FLAMINGO RD 16B
LAS VEGAS NV
89119-5276
US

IV. Provider business mailing address

1621 E FLAMINGO RD 16B
LAS VEGAS NV
89119-5276
US

V. Phone/Fax

Practice location:
  • Phone: 702-696-0506
  • Fax: 702-696-0532
Mailing address:
  • Phone: 702-696-0506
  • Fax: 702-696-0532

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code173000000X
TaxonomyLegal Medicine
License Number8699
License Number StateNV

VIII. Authorized Official

Name: DR. ROSNER P LUSS
Title or Position: OWNER
Credential: M.D.
Phone: 702-696-0506