Provider Demographics
NPI:1649978396
Name:NEVADA ONCOLOGY SPECIALISTS TOY GOODMAN SAMLOWSKI PC
Entity type:Organization
Organization Name:NEVADA ONCOLOGY SPECIALISTS TOY GOODMAN SAMLOWSKI PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:
Authorized Official - Last Name:TRANQUILLO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-604-5274
Mailing Address - Street 1:192 WEBSTER WAY
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89074-0622
Mailing Address - Country:US
Mailing Address - Phone:702-604-5274
Mailing Address - Fax:
Practice Address - Street 1:9139 W RUSSELL RD
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89148-1250
Practice Address - Country:US
Practice Address - Phone:702-604-5274
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-22
Last Update Date:2025-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Multi-Specialty
No2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation OncologyGroup - Multi-Specialty