Provider Demographics
NPI:1962408179
Name:NALBONE, VINCENT PETER (MD)
Entity type:Individual
Prefix:
First Name:VINCENT
Middle Name:PETER
Last Name:NALBONE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9111 W RUSSELL RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89148-1245
Mailing Address - Country:US
Mailing Address - Phone:702-312-3333
Mailing Address - Fax:702-312-1144
Practice Address - Street 1:9111 W RUSSELL RD
Practice Address - Street 2:SUITE A
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89148-1245
Practice Address - Country:US
Practice Address - Phone:702-312-3333
Practice Address - Fax:702-312-1144
Is Sole Proprietor?:No
Enumeration Date:2005-06-22
Last Update Date:2009-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV8303207YS0123X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207YS0123XAllopathic & Osteopathic PhysiciansOtolaryngologyFacial Plastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
G47543Medicare UPIN
31697Medicare ID - Type Unspecified