MEDICARE: ANASTASIA GENNADIEVNA GRIGOROVA

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	171R00000X	Interpreter

General Provider Information

NPI Number	:	1336954270
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANASTASIA GENNADIEVNA GRIGOROVA

Provider Business Mailing Address
First Line	:	5250 S RAINBOW BLVD UNIT 1088
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89118-0628
Country	:	US
Telephone Number	:	702-234-4635
Fax Number	:

Provider Business Practice Location Address
First Line	:	5250 S RAINBOW BLVD UNIT 1088
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89118-0628
Country	:	US
Telephone Number	:	702-234-4635
Fax Number	:

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

Provider Enumeration Date	:	02/10/2025
Last Update Date	:	02/10/2025

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Directions to “ ANASTASIA GENNADIEVNA GRIGOROVA ” Practice Location

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