Provider Demographics
NPI:1225086937
Name:PERINATAL ASSSOCIATES OF NORTHERN NEVADA, LLP
Entity Type:Organization
Organization Name:PERINATAL ASSSOCIATES OF NORTHERN NEVADA, LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:EARLE
Authorized Official - Middle Name:Y
Authorized Official - Last Name:OKI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:775-829-0573
Mailing Address - Street 1:1500 E 2ND ST STE 203
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89502-1196
Mailing Address - Country:US
Mailing Address - Phone:775-829-0573
Mailing Address - Fax:775-329-8528
Practice Address - Street 1:1500 E 2ND ST
Practice Address - Street 2:SUITE 108
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89502-1262
Practice Address - Country:US
Practice Address - Phone:775-829-0573
Practice Address - Fax:775-329-8528
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-05
Last Update Date:2017-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV6694207VM0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VM0101XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyMaternal & Fetal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVV100068Medicare PIN