MEDICARE: QUICKND PAIN CARE

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	207LP2900X	Pain Medicine (Anesthesiology) Physician	11543	NY

General Provider Information

NPI Number	:	1225385842
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	QUICKND PAIN CARE

Provider Business Mailing Address
First Line	:	3111 S MARYLAND PKWY STE 200
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89109-2319
Country	:	US
Telephone Number	:	702-732-7407
Fax Number	:

Provider Business Practice Location Address
First Line	:	3111 S MARYLAND PKWY STE 200
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89109-2319
Country	:	US
Telephone Number	:	702-732-7407
Fax Number	:

Authorized Official
Title or Position	:	MD
Name	:	MARIO TARQUINO
Credential	:	MD
Telephone Number	:	702-732-7407

Provider Enumeration Date	:	08/14/2012
Last Update Date	:	08/14/2012

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Directions to “QUICKND PAIN CARE ” Practice Location

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