| Modern Psychiatry Pllc | |
|
10014 Pipestone St Las Vegas NV 89141-8668 | |
| (702) 318-7920 | |
| (702) 745-0531 |
| Full Name | Modern Psychiatry Pllc |
|---|---|
| Speciality | Clinic/Center |
| Location | 10014 Pipestone St, Las Vegas, Nevada |
| Authorized Official Name and Position | Benson Wachira Wanjohi (OWNER) |
| Authorized Official Contact | 7854089274 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Modern Psychiatry Pllc 8665 W Flamingo Rd Ste 118 Las Vegas NV 89147-8624 Ph: (702) 318-7920 | Modern Psychiatry Pllc 10014 Pipestone St Las Vegas NV 89141-8668 Ph: (702) 318-7920 |
| NPI Number | 1164148565 |
|---|---|
| Provider Enumeration Date | 10/17/2022 |
| Last Update Date | 10/17/2022 |
| Certification Date | 10/17/2022 |
| Medicare PECOS PAC ID | 0840669537 |
|---|---|
| Medicare Enrollment ID | O20221220002342 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164148565 | NPI | - | NPPES |
| Provider Name | Leah Gaitho |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194355107 PECOS PAC ID: 1759706179 Enrollment ID: I20200803000733 |
| Provider Name | Benson Wanjohi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407441405 PECOS PAC ID: 8628475035 Enrollment ID: I20220404002315 |
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