Healthcare Provider Details

I. General information

NPI: 1790609253
Provider Name (Legal Business Name): ERIC J MONTOYA DOM
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/07/2026
Last Update Date: 08/07/2026
Certification Date: 08/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4118 CENTRAL AVE SE STE A
ALBUQUERQUE NM
87108-1177
US

IV. Provider business mailing address

32 CLAREMONT AVE NW
ALBUQUERQUE NM
87107-1451
US

V. Phone/Fax

Practice location:
  • Phone: 505-232-2870
  • Fax: 844-955-1801
Mailing address:
  • Phone: 505-232-2870
  • Fax: 844-955-1801

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberDOM1060
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: