MEDICARE: NEUROLOGICAL ASSOCIATES OF NEVADA

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	174400000X	Specialist

General Provider Information

NPI Number	:	1669697470
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NEUROLOGICAL ASSOCIATES OF NEVADA

Provider Business Mailing Address
First Line	:	3960 HOWARD HUGHES PKWY STE 500
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89169-5988
Country	:	US
Telephone Number	:	702-951-7250
Fax Number	:	702-946-5000

Provider Business Practice Location Address
First Line	:	3960 HOWARD HUGHES PKWY STE 500
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89169-5988
Country	:	US
Telephone Number	:	702-951-7250
Fax Number	:	702-946-5000

Authorized Official
Title or Position	:	CEO
Name	:	MR. RICHARD F MOORE
Credential	:
Telephone Number	:	702-951-7250

Provider Enumeration Date	:	04/16/2007
Last Update Date	:	07/10/2009

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