Healthcare Provider Details
I. General information
NPI: 1487289773
Provider Name (Legal Business Name): ACCESS ENDOCRINOLOGY LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/06/2020
Last Update Date: 12/26/2024
Certification Date: 12/26/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
100 SUN AVE NE STE 650
ALBUQUERQUE NM
87109-4670
US
IV. Provider business mailing address
529 MONTCLAIRE DR SE
ALBUQUERQUE NM
87108-3348
US
V. Phone/Fax
- Phone: 505-835-6767
- Fax: 505-545-6727
- Phone: 575-454-9271
- Fax: 505-545-6727
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RE0101X |
| Taxonomy | Endocrinology, Diabetes & Metabolism Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ANITA
LEE
SLOAN
Title or Position: PHYSICIAN ADMINISTRATOR
Credential: MD
Phone: 505-835-6767