MEDICARE: NICHOLAS PAUL CUTUNILLI OD

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	OPT-002267	AZ

General Provider Information

NPI Number	:	1932694197
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NICHOLAS PAUL CUTUNILLI OD

Provider Business Mailing Address
First Line	:	7090 N DURANGO DR STE 110
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89149-4495
Country	:	US
Telephone Number	:	702-220-3937
Fax Number	:	702-655-3182

Provider Business Practice Location Address
First Line	:	7090 N DURANGO DR STE 110
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89149-4495
Country	:	US
Telephone Number	:	702-220-3937
Fax Number	:	702-655-3182

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

Provider Enumeration Date	:	06/28/2018
Last Update Date	:	03/27/2025

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