Provider Demographics
NPI:1295288967
Name:HRONEK, IVAN
Entity type:Individual
Prefix:
First Name:IVAN
Middle Name:
Last Name:HRONEK
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7341 W CHARLESTON BLVD STE 150
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89117-1578
Mailing Address - Country:US
Mailing Address - Phone:702-268-8542
Mailing Address - Fax:702-268-8719
Practice Address - Street 1:7341 W CHARLESTON BLVD STE 150
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89117-1578
Practice Address - Country:US
Practice Address - Phone:702-268-8542
Practice Address - Fax:702-268-8719
Is Sole Proprietor?:No
Enumeration Date:2016-07-29
Last Update Date:2020-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103G00000X, 390200000X
NVPY0879103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program