MEDICARE: ROSNER PATRICK LUSS MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	8699	NV

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	964206	OTHER	AZ	MCAID
2	29D2033945	OTHER	NV	CLIA
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1144270349
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROSNER PATRICK LUSS MD

Provider Business Mailing Address
First Line	:	1621 E FLAMINGO RD
Second Line	:	B-16
City	:	LAS VEGAS
State	:	NV
Zip	:	89119-5276
Country	:	US
Telephone Number	:	702-696-0506
Fax Number	:	702-696-0532

Provider Business Practice Location Address
First Line	:	1621 E FLAMINGO RD
Second Line	:	B-16
City	:	LAS VEGAS
State	:	NV
Zip	:	89119-5276
Country	:	US
Telephone Number	:	702-696-0506
Fax Number	:	702-696-0532

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/11/2006
Last Update Date	:	06/11/2012

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