Healthcare Provider Details

I. General information

NPI: 1932315975
Provider Name (Legal Business Name): CLAUDIA MARIA ALFARO-ANDRICK MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/15/2007
Last Update Date: 01/10/2022
Certification Date: 01/10/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4208 CENTRAL AVE SW
ALBUQUERQUE NM
87105-1695
US

IV. Provider business mailing address

PO BOX 740018
ATLANTA GA
30374-0018
US

V. Phone/Fax

Practice location:
  • Phone: 505-777-3001
  • Fax: 505-808-4977
Mailing address:
  • Phone: 312-773-9730
  • Fax: 773-866-8014

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD2009-0524
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: