Provider Demographics
NPI:1144232786
Name:WOMEN'S CANCER CENTER OF NEVADA INC
Entity Type:Organization
Organization Name:WOMEN'S CANCER CENTER OF NEVADA INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:NICOLA
Authorized Official - Middle Name:
Authorized Official - Last Name:SPIRTOS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:702-325-0585
Mailing Address - Street 1:700 SHADOW LN STE 370
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89106-4159
Mailing Address - Country:US
Mailing Address - Phone:702-693-6870
Mailing Address - Fax:702-693-6899
Practice Address - Street 1:700 SHADOW LN STE 370
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89106-4159
Practice Address - Country:US
Practice Address - Phone:702-693-6870
Practice Address - Fax:702-693-6899
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-12
Last Update Date:2022-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
174400000X
NV1001112-650207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
No207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVG94931Medicare UPIN
NVV31359Medicare ID - Type Unspecified
NVA22076Medicare UPIN
NVA49940Medicare UPIN
NVV34215Medicare ID - Type Unspecified
NVV101610Medicare ID - Type Unspecified