1649978396 NPI number — NEVADA ONCOLOGY SPECIALISTS TOY GOODMAN SAMLOWSKI PC

Table of content: DR. ANTHONY ITALO SQUILLARO M.D. (NPI 1699155432)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1649978396 NPI number — NEVADA ONCOLOGY SPECIALISTS TOY GOODMAN SAMLOWSKI PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NEVADA ONCOLOGY SPECIALISTS TOY GOODMAN SAMLOWSKI PC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1649978396
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/04/2026
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
192 WEBSTER WAY
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HENDERSON
Provider Business Mailing Address State Name:
NV
Provider Business Mailing Address Postal Code:
89074-0622
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
702-604-5274
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
9139 W RUSSELL RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LAS VEGAS
Provider Business Practice Location Address State Name:
NV
Provider Business Practice Location Address Postal Code:
89148-1250
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
702-473-1757
Provider Business Practice Location Address Fax Number:
702-725-4348
Provider Enumeration Date:
02/22/2023

Additional Information

Authorized Official

Authorized Official Last Name:
TRANQUILLO
Authorized Official First Name:
SUSAN
Authorized Official Middle Name:
Authorized Official Title or Position:
ADMINISTRATIVE DIRECTOR
Authorized Official Telephone Number:
702-604-5274

Provider Taxonomy Codes

  • Taxonomy code: 2085R0001X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207RH0003X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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