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NPI Code Detail

MEDICARE: SUBA PSYCHIATRY PLLC

MEDICARE: SUBA PSYCHIATRY PLLC
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
12084P0800XPsychiatry Physician13792NV

General Provider Information

NPI Number : 1396018511
Entity Type Code : Organization
Provider Name (Legal Business Name) : SUBA PSYCHIATRY PLLC
Provider Business Mailing Address
First Line : 1530 E SAHARA AVE
Second Line :
City : LAS VEGAS
State : NV
Zip : 89104-3439
Country : US
Telephone Number : 845-659-6317
Fax Number : 702-566-4575
Provider Business Practice Location Address
First Line : 1530 E SAHARA AVE
Second Line :
City : LAS VEGAS
State : NV
Zip : 89104-3439
Country : US
Telephone Number : 845-659-6317
Fax Number : 702-566-4575
Authorized Official
Title or Position : OWNER
Name : FAISAL SUBA
Credential : MD
Telephone Number : 702-685-0674
Provider Enumeration Date : 02/18/2012
Last Update Date : 03/15/2012

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Directions to “SUBA PSYCHIATRY PLLC ” Practice Location

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