Provider Demographics
NPI:1902597768
Name:NITAI ANESTHESIA GROUP PLLC
Entity Type:Organization
Organization Name:NITAI ANESTHESIA GROUP PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:VISHAL
Authorized Official - Middle Name:
Authorized Official - Last Name:GANDOTRA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:702-945-2436
Mailing Address - Street 1:1930 VILLAGE CENTER CIR STE 3-708
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89134-6299
Mailing Address - Country:US
Mailing Address - Phone:702-945-2436
Mailing Address - Fax:702-487-3197
Practice Address - Street 1:1930 VILLAGE CENTER CIR STE 3-708
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89134-6299
Practice Address - Country:US
Practice Address - Phone:702-945-2436
Practice Address - Fax:702-487-3197
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-15
Last Update Date:2023-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Multi-Specialty
No367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Multi-Specialty