Individual
GERARDO A MARIANO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4462 FARMCREST DR, LAS VEGAS, NV 89121-4906
(702) 433-2879
Mailing address
4462 FARMCREST DR, LAS VEGAS, NV 89121-4906
(702) 433-2879
(702) 433-2879
Taxonomy
Speciality
Code
Description
License number
State
3104A0625X
Assisted Living Facility (Mental Illness)
Primary
297-AGC-32
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
260502327
—
NV
Enumeration date
06/07/2019
Last updated
06/07/2019
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