Individual
DR. JONATHAN P PEZANOSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
10619 PROFESSIONAL CIR, RENO, NV 89521-5831
(775) 852-4848
(775) 850-5763
Mailing address
10619 PROFESSIONAL CIR, RENO, NV 89521-5831
(775) 852-4848
(775) 850-5763
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
12280
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
VWCGZB
GROUP MEDICARE PIN
NV
Enumeration date
06/15/2006
Last updated
10/08/2007
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