MEDICARE: BRITTANY RYS R.EEG T.

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	246ZE0500X	EEG Specialist/Technologist	4535
2	246ZE0600X	Electroneurodiagnostic Specialist/Technologist	4535

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	4535	OTHER		R.EEG T.

General Provider Information

NPI Number	:	1154715613
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRITTANY RYS R.EEG T.

Provider Business Mailing Address
First Line	:	3644 S FORT APACHE RD
Second Line	:	#2140
City	:	LAS VEGAS
State	:	NV
Zip	:	89147-3409
Country	:	US
Telephone Number	:	708-415-7212
Fax Number	:

Provider Business Practice Location Address
First Line	:	9811 W CHARLESTON BLVD # 2-641
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89117-7528
Country	:	US
Telephone Number	:	855-864-4322
Fax Number	:	888-315-4512

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

Provider Enumeration Date	:	03/23/2015
Last Update Date	:	08/18/2015

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Directions to “ BRITTANY RYS R.EEG T.” Practice Location

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