Healthcare Provider Details

I. General information

NPI: 1376221937
Provider Name (Legal Business Name): MARY NVART ESKANDARIAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/05/2023
Last Update Date: 01/22/2025
Certification Date: 01/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6900 N PECOS RD
NORTH LAS VEGAS NV
89086-4400
US

IV. Provider business mailing address

8360 MONTECITO POINTE DR APT 3082
LAS VEGAS NV
89149-4790
US

V. Phone/Fax

Practice location:
  • Phone: 818-321-7409
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number35901
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: