Healthcare Provider Details

I. General information

NPI: 1881798981
Provider Name (Legal Business Name): MAIMONIDES SLEEP ARTS & SCIENCES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/11/2006
Last Update Date: 09/06/2024
Certification Date: 09/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3500 COMANCHE RD NE STE C
ALBUQUERQUE NM
87107-4546
US

IV. Provider business mailing address

3500 COMANCHE RD NE STE C
ALBUQUERQUE NM
87107-4546
US

V. Phone/Fax

Practice location:
  • Phone: 505-998-7200
  • Fax: 505-998-7220
Mailing address:
  • Phone: 505-998-7208
  • Fax: 505-998-7220

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207QS1201X
TaxonomySleep Medicine (Family Medicine) Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QS1200X
TaxonomySleep Disorder Diagnostic Clinic/Center
License Number84207
License Number StateNM

VIII. Authorized Official

Name: MR. DAWID R RECHUL
Title or Position: MEDICAL DIRECTOR
Credential: MD
Phone: 505-998-7200