| Advanced Health & Age Rejuvenation Center | |
|
653 N Town Center Dr Ste 407 Las Vegas NV 89144-0505 | |
| (702) 368-2244 | |
| (702) 368-2242 |
| Full Name | Advanced Health & Age Rejuvenation Center |
|---|---|
| Speciality | Internal Medicine |
| Location | 653 N Town Center Dr Ste 407, Las Vegas, Nevada |
| Authorized Official Name and Position | Stephen C Castorino (PRESIDENT) |
| Authorized Official Contact | 7023682244 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Advanced Health & Age Rejuvenation Center 1930 Village Center Cir # 3-633 Las Vegas NV 89134-6299 Ph: (702) 368-2244 | Advanced Health & Age Rejuvenation Center 653 N Town Center Dr Ste 407 Las Vegas NV 89144-0505 Ph: (702) 368-2244 |
| NPI Number | 1609106814 |
|---|---|
| Provider Enumeration Date | 01/11/2010 |
| Last Update Date | 12/08/2010 |
| Medicare PECOS PAC ID | 6103952759 |
|---|---|
| Medicare Enrollment ID | O20100407000393 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609106814 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| 363LP2300X | Nurse Practitioner - Primary Care | (* (Not Available)) | Secondary |
| Provider Name | Stephen C Castorino |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1942413315 PECOS PAC ID: 5092801910 Enrollment ID: I20100407000481 |
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