MEDICARE: MOISES JULIUS ALBANO

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	225200000X	Physical Therapy Assistant	A-0811	NV

General Provider Information

NPI Number	:	1720461551
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MOISES JULIUS ALBANO

Provider Business Mailing Address
First Line	:	3213 W CHARLESTON BLVD
Second Line	:	105
City	:	LAS VEGAS
State	:	NV
Zip	:	89102-1962
Country	:	US
Telephone Number	:	702-570-6222
Fax Number	:

Provider Business Practice Location Address
First Line	:	3213 W CHARLESTON BLVD
Second Line	:	105
City	:	LAS VEGAS
State	:	NV
Zip	:	89102-1962
Country	:	US
Telephone Number	:	702-570-6222
Fax Number	:

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

Provider Enumeration Date	:	06/29/2015
Last Update Date	:	06/29/2015

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Directions to “ MOISES JULIUS ALBANO ” Practice Location

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