Provider Demographics
NPI:1639487390
Name:PETER A MANSKY MD CONSULTANT LTD
Entity Type:Organization
Organization Name:PETER A MANSKY MD CONSULTANT LTD
Other - Org Name:CLINICAL SERVICES OF NEVADA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PETER
Authorized Official - Middle Name:A
Authorized Official - Last Name:MANSKY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:702-405-7285
Mailing Address - Street 1:9811 W CHARLESTON BLVD STE 2-735
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89117-7528
Mailing Address - Country:US
Mailing Address - Phone:702-405-7285
Mailing Address - Fax:877-324-7915
Practice Address - Street 1:4735 S DURANGO DR STE 101
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89147-8164
Practice Address - Country:US
Practice Address - Phone:702-405-7285
Practice Address - Fax:877-324-7915
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-15
Last Update Date:2010-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084A0401XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction MedicineGroup - Multi-Specialty
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty