Provider Demographics
NPI:1508062506
Name:MINUSKIN, TAL AARON (MD)
Entity Type:Individual
Prefix:
First Name:TAL
Middle Name:AARON
Last Name:MINUSKIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:851 S RAMPART BLVD STE 130
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89145-4884
Mailing Address - Country:US
Mailing Address - Phone:702-823-1333
Mailing Address - Fax:702-823-1190
Practice Address - Street 1:851 S RAMPART BLVD STE 130
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89145-4884
Practice Address - Country:US
Practice Address - Phone:702-823-1333
Practice Address - Fax:702-823-1190
Is Sole Proprietor?:No
Enumeration Date:2007-06-26
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN46719208000000X
NV15337208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV100537177Medicaid