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General NPI Number Information
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NPI Number | 1740681824
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Entity Type | Organization
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Legal Business Name | INTERNATIONAL NEUROSCIENCE CONSULTANTS
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Dates
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Enumeration Date | 09/09/2014
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Last Update Date | 09/09/2014
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Provider Practice Location Address
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Address Line | 716 S 6TH ST
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City | LAS VEGAS
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State | NV
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Zip | 89101-6922
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Country | US
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Telephone | 702-382-1960
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Fax |
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Provider Business Mailing Address
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Address Line | 716 S 6TH ST
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City | LAS VEGAS
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State | NV
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Zip | 89101-6922
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Country | US
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Telephone | 702-382-1960
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ALBERT CAPANNA
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Credential | M.D.
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Telephone | 702-382-1960
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207T00000X
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Taxonomy Name | Neurological Surgery Physician
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License Number | 4594
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License Number State | NV
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