Provider Demographics
NPI:1407160351
Name:ROSHAN, NADIA (OD)
Entity Type:Individual
Prefix:DR
First Name:NADIA
Middle Name:
Last Name:ROSHAN
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8230 W SAHARA AVE
Mailing Address - Street 2:SUITE 121
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89117-8959
Mailing Address - Country:US
Mailing Address - Phone:702-944-2001
Mailing Address - Fax:702-947-0474
Practice Address - Street 1:10870 W CHARLESTON BLVD
Practice Address - Street 2:STE 105
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89135-1158
Practice Address - Country:US
Practice Address - Phone:702-877-3937
Practice Address - Fax:702-877-3935
Is Sole Proprietor?:No
Enumeration Date:2010-08-03
Last Update Date:2013-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA14050152W00000X
NV690152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist