MEDICARE: RAYMOND F. GORCZYCA PA-C

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	363A00000X	Physician Assistant	374	NV
2	363A00000X	Physician Assistant	PA374	NV

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1861470692
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RAYMOND F. GORCZYCA PA-C

Provider Business Mailing Address
First Line	:	5320 S. RAINBOW BLVD
Second Line	:	SUITE 282
City	:	LAS VEGAS
State	:	NV
Zip	:	89118-1895
Country	:	US
Telephone Number	:	702-737-3808
Fax Number	:	702-737-7364

Provider Business Practice Location Address
First Line	:	5320 S. RAINBOW BLVD
Second Line	:	SUITE 282
City	:	LAS VEGAS
State	:	NV
Zip	:	89118-1895
Country	:	US
Telephone Number	:	702-737-3808
Fax Number	:	702-737-7364

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

Provider Enumeration Date	:	01/03/2006
Last Update Date	:	04/20/2009

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Directions to “ RAYMOND F. GORCZYCA PA-C” Practice Location

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