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Individual

DR. BRIAN RICHARD PASSALACQUA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
123 17TH STREET, BRIGHAM BLDG. MAIL STOP 316, RENO, NV 89557
(775) 784-1533
(775) 784-8075
Mailing address
401 WEST 2ND STREET, #227, NELSON BLDG. MS 353, RENO, NV 89503
(775) 784-1223
(775) 327-2006

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
6822
NV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100506503
NV
Enumeration date
03/19/2007
Last updated
03/01/2011
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