Provider Demographics
NPI:1275652109
Name:VINCENT P NALBONE M D LTD
Entity Type:Organization
Organization Name:VINCENT P NALBONE M D LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:GERALDINE
Authorized Official - Middle Name:
Authorized Official - Last Name:SALALAC
Authorized Official - Suffix:
Authorized Official - Credentials:NURSE PRACTITIONER
Authorized Official - Phone:702-312-3333
Mailing Address - Street 1:9111 W RUSSELL ROAD
Mailing Address - Street 2:SUITE A
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89148-1240
Mailing Address - Country:US
Mailing Address - Phone:702-312-3333
Mailing Address - Fax:702-312-1144
Practice Address - Street 1:9111 W RUSSELL ROAD
Practice Address - Street 2:SUITE A
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89148-1240
Practice Address - Country:US
Practice Address - Phone:702-312-3333
Practice Address - Fax:702-312-1144
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-29
Last Update Date:2023-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV8303207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV2019920Medicaid
NVU31697Medicare ID - Type Unspecified
NVV103503Medicare PIN