Individual
ROSE MARIE GUSTILO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2518 DARDA ST, HENDERSON, NV 89044-1588
(702) 617-3597
Mailing address
2518 DARDA ST, HENDERSON, NV 89044-1588
(702) 617-3597
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
0101050885
VA
2084P0800X
Psychiatry Physician
Primary
D23777
MD
2084P0800X
Psychiatry Physician
MD035835E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
136841
—
AZ
Enumeration date
10/18/2006
Last updated
07/20/2011
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