Healthcare Provider Details

I. General information

NPI: 1902839400
Provider Name (Legal Business Name): NORMA PEREZ-ABELE MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/08/2006
Last Update Date: 10/15/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3436 ISLETA BLVD. SW
ALBUQUERQUE NM
87105
US

IV. Provider business mailing address

PO BOX 26666
ALBUQUERQUE NM
87125-6666
US

V. Phone/Fax

Practice location:
  • Phone: 505-462-7777
  • Fax: 505-462-7880
Mailing address:
  • Phone: 505-923-5356
  • Fax: 505-923-5354

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD2004-0553
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: