| C Philip Colosimo Ph D & Associates Ltd | |
|
501 S Rancho Dr Ste C14 Las Vegas NV 89106-4831 | |
| (702) 384-7433 | |
| (702) 366-1204 |
| Full Name | C Philip Colosimo Ph D & Associates Ltd |
|---|---|
| Speciality | Psychologist |
| Location | 501 S Rancho Dr Ste C14, Las Vegas, Nevada |
| Authorized Official Name and Position | Charles Philip Colosimo (PRESIDENT) |
| Authorized Official Contact | 7023847433 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| C Philip Colosimo Ph D & Associates Ltd 501 S Rancho Dr Ste C14 Las Vegas NV 89106-4831 Ph: (702) 384-7433 | C Philip Colosimo Ph D & Associates Ltd 501 S Rancho Dr Ste C14 Las Vegas NV 89106-4831 Ph: (702) 384-7433 |
| NPI Number | 1952925018 |
|---|---|
| Provider Enumeration Date | 06/04/2020 |
| Last Update Date | 10/01/2020 |
| Certification Date | 10/01/2020 |
| Medicare PECOS PAC ID | 3173940822 |
|---|---|
| Medicare Enrollment ID | O20210303001302 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952925018 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
| Provider Name | Charles Philip Colosimo |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1699831875 PECOS PAC ID: 4183662372 Enrollment ID: I20050419000635 |
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