Provider Demographics
NPI:1376622456
Name:ORNSTEIN, PHILIP (DPM)
Entity Type:Individual
Prefix:
First Name:PHILIP
Middle Name:
Last Name:ORNSTEIN
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5450 W SAHARA AVE
Mailing Address - Street 2:STE. 130
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89146-0380
Mailing Address - Country:US
Mailing Address - Phone:702-388-1006
Mailing Address - Fax:702-388-1751
Practice Address - Street 1:5450 W SAHARA AVE
Practice Address - Street 2:STE. 130
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89146-0380
Practice Address - Country:US
Practice Address - Phone:702-388-1006
Practice Address - Fax:702-388-1751
Is Sole Proprietor?:No
Enumeration Date:2006-11-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV47213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
0803622OtherAETNA
10050OtherPACIFICARE
10979OtherNEVADACARE
653976OtherUNITED HC
8608645000OtherCULINARY
8608645000OtherCULINARY
V31750Medicare ID - Type Unspecified