Provider Demographics
NPI:1457403057
Name:ABSOLUTE FOOT CARE SPECIALISTS, INC
Entity Type:Organization
Organization Name:ABSOLUTE FOOT CARE SPECIALISTS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:NOAH
Authorized Official - Middle Name:
Authorized Official - Last Name:LEVINE
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:702-839-2010
Mailing Address - Street 1:7125 GRAND MONTECITO PKWY
Mailing Address - Street 2:ST. 110
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89149-0260
Mailing Address - Country:US
Mailing Address - Phone:702-839-2010
Mailing Address - Fax:702-839-2977
Practice Address - Street 1:7125 GRAND MONTECITO PKWY
Practice Address - Street 2:ST. 110
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89149-0260
Practice Address - Country:US
Practice Address - Phone:702-839-2010
Practice Address - Fax:702-839-2977
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-17
Last Update Date:2012-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV0110213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVP00733933OtherRAILROAD MEDICARE
NVDP1514OtherRAILROAD MEDICARE
NVP00733931OtherRAILROAD MEDICARE
NV002102012Medicaid
NVBJ733Medicare PIN
NVP00733931OtherRAILROAD MEDICARE
NVDP1514OtherRAILROAD MEDICARE
NVDH043ZMedicare PIN
NVBJ752Medicare PIN