| Dominic Ricciardi Md Ltd | |
|
8285 W Arby Ave Ste 145 Las Vegas NV 89113-2236 | |
| (702) 492-8281 | |
| (702) 491-8279 |
| Full Name | Dominic Ricciardi Md Ltd |
|---|---|
| Speciality | Internal Medicine |
| Location | 8285 W Arby Ave Ste 145, Las Vegas, Nevada |
| Authorized Official Name and Position | Dominic Ricciardi (PRESIDENT) |
| Authorized Official Contact | 7024928281 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dominic Ricciardi Md Ltd 6284 S Rainbow Blvd Suite 110 Las Vegas NV 89118-3244 Ph: (702) 492-8281 | Dominic Ricciardi Md Ltd 8285 W Arby Ave Ste 145 Las Vegas NV 89113-2236 Ph: (702) 492-8281 |
| NPI Number | 1023212552 |
|---|---|
| Provider Enumeration Date | 06/11/2007 |
| Last Update Date | 07/21/2022 |
| Medicare PECOS PAC ID | 9234220542 |
|---|---|
| Medicare Enrollment ID | O20070801000037 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023212552 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | NV20061204813 (Nevada) | Primary |
| Provider Name | Dominic Ricciardi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1720198914 PECOS PAC ID: 0547220568 Enrollment ID: I20070626000356 |
| Provider Name | Olga Maratovna Borozinski |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184495848 PECOS PAC ID: 5092154385 Enrollment ID: I20240419000552 |
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