Provider Demographics
NPI:1215568373
Name:NITIN J. ENGINEER MD PLASTIC SURGERY PLLC
Entity Type:Organization
Organization Name:NITIN J. ENGINEER MD PLASTIC SURGERY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:NITIN
Authorized Official - Middle Name:J
Authorized Official - Last Name:ENGINEER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:702-907-2222
Mailing Address - Street 1:1364 ENCHANTED RIVER DR
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89012-7276
Mailing Address - Country:US
Mailing Address - Phone:702-907-2222
Mailing Address - Fax:702-907-4444
Practice Address - Street 1:2821 W HORIZON RIDGE PKWY STE 130
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89052-4429
Practice Address - Country:US
Practice Address - Phone:702-907-2222
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-28
Last Update Date:2020-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0105XAllopathic & Osteopathic PhysiciansSurgerySurgery of the HandGroup - Multi-Specialty
No208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty
No2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive SurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV13102OtherNV MEDICAL LICENSE