MEDICARE: ROSNER P. LUSS MD LTD

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	173000000X	Legal Medicine	8699	NV

Other Identifiers

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

General Provider Information

NPI Number	:	1295967784
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ROSNER P. LUSS MD LTD

Provider Business Mailing Address
First Line	:	1621 E FLAMINGO RD
Second Line	:	16B
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	:	16B
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	:	OWNER
Name	:	DR. ROSNER P LUSS
Credential	:	M.D.
Telephone Number	:	702-696-0506

Provider Enumeration Date	:	08/17/2009
Last Update Date	:	06/11/2012

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