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NPI Code Detail

MEDICARE: CHRISTINE DOMBROSKI PT

MEDICARE: CHRISTINE DOMBROSKI PT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist2881NM

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1790807576
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHRISTINE DOMBROSKI PT
Provider Business Mailing Address
First Line : 6401 ACADEMY RD NE
Second Line : APT. 120
City : ALBUQUERQUE
State : NM
Zip : 87109-3350
Country : US
Telephone Number : 505-205-6404
Fax Number :
Provider Business Practice Location Address
First Line : 713 CALIFORNIA ST SE
Second Line :
City : ALBUQUERQUE
State : NM
Zip : 87108-3707
Country : US
Telephone Number : 505-265-2168
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/04/2007
Last Update Date : 07/09/2007

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Directions to “ CHRISTINE DOMBROSKI PT” Practice Location

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