Healthcare Provider Details

I. General information

NPI: 1184291338
Provider Name (Legal Business Name): NICHOLAS LIQUIGLI DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/07/2021
Last Update Date: 07/09/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

75 PRINGLE WAY STE 401
RENO NV
89502-1476
US

IV. Provider business mailing address

75 PRINGLE WAY STE 401
RENO NV
89502-1476
US

V. Phone/Fax

Practice location:
  • Phone: 775-982-2970
  • Fax:
Mailing address:
  • Phone: 775-982-2970
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number5151015129
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code2084E0001X
TaxonomyEpilepsy Physician
License Number20A24196
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code2084E0001X
TaxonomyEpilepsy Physician
License NumberDO4143
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: