Healthcare Provider Details
I. General information
NPI: 1962447383
Provider Name (Legal Business Name): ROTHSTEIN AND SHAPIRO MDS LTD
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/19/2006
Last Update Date: 06/26/2024
Certification Date: 06/26/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2135 GREEN VISTA DR 109
SPARKS NV
89431-8544
US
IV. Provider business mailing address
2135 GREEN VISTA DR 109
SPARKS NV
89431-8544
US
V. Phone/Fax
- Phone: 775-359-5010
- Fax: 775-359-5076
- Phone: 775-359-5010
- Fax: 775-359-5076
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207K00000X |
| Taxonomy | Allergy & Immunology Physician |
| License Number | 2739 |
| License Number State | NV |
VIII. Authorized Official
Name: DR.
BORIS
LOKSHIN
Title or Position: OWNER
Credential: M.D.
Phone: 775-747-5050