Healthcare Provider Details

I. General information

NPI: 1922183649
Provider Name (Legal Business Name): HEMATOLOGY-ONCOLOGY ASSOCIATES P C
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/25/2006
Last Update Date: 02/13/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1001 COAL AVE SE
ALBUQUERQUE NM
87106-5205
US

IV. Provider business mailing address

1001 COAL AVE SE
ALBUQUERQUE NM
87106-5205
US

V. Phone/Fax

Practice location:
  • Phone: 505-938-5858
  • Fax: 505-938-5858
Mailing address:
  • Phone: 505-938-5858
  • Fax: 505-938-5858

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number StateNM

VIII. Authorized Official

Name: MRS. KARI YOUNG
Title or Position: CFO
Credential:
Phone: 505-938-5858