MEDICARE: DR. CHRISTINA MARIE FACCINTO-MAYER O.D.

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	152W00000X	Optometrist	500	NV

General Provider Information

NPI Number	:	1851445647
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHRISTINA MARIE FACCINTO-MAYER O.D.

Provider Business Mailing Address
First Line	:	1320 E PEBBLE RD
Second Line	:	SUITE 100
City	:	LAS VEGAS
State	:	NV
Zip	:	89123-3105
Country	:	US
Telephone Number	:	702-818-3100
Fax Number	:	702-485-6085

Provider Business Practice Location Address
First Line	:	1320 E PEBBLE RD
Second Line	:	SUITE 100
City	:	LAS VEGAS
State	:	NV
Zip	:	89123-3105
Country	:	US
Telephone Number	:	702-818-3100
Fax Number	:	702-485-6085

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

Provider Enumeration Date	:	01/22/2007
Last Update Date	:	07/23/2010

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