Healthcare Provider Details

I. General information

NPI: 1376092403
Provider Name (Legal Business Name): RADIUS ANESTHESIA OF NEW MEXICO LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/30/2016
Last Update Date: 01/18/2023
Certification Date: 01/18/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4801 LANG AVE NE STE 110
ALBUQUERQUE NM
87109-4475
US

IV. Provider business mailing address

111 TOWN SQUARE PL STE 420
JERSEY CITY NJ
07310-1724
US

V. Phone/Fax

Practice location:
  • Phone: 888-589-8550
  • Fax: 201-604-6571
Mailing address:
  • Phone: 888-589-8550
  • Fax: 201-604-6571

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberMD2015-0199
License Number StateNM

VIII. Authorized Official

Name: DR. HAROON W CHAUDHRY
Title or Position: PRESIDENT
Credential: MD
Phone: 917-621-6854