Healthcare Provider Details

I. General information

NPI: 1376565952
Provider Name (Legal Business Name): PERINATAL ASSOCIATES OF NEW MEXICO, LTD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/24/2006
Last Update Date: 08/20/2025
Certification Date: 08/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 CEDAR ST SE STE 405
ALBUQUERQUE NM
87106-4924
US

IV. Provider business mailing address

201 CEDAR ST SE STE 405
ALBUQUERQUE NM
87106-4924
US

V. Phone/Fax

Practice location:
  • Phone: 505-764-9535
  • Fax:
Mailing address:
  • Phone: 505-764-9535
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VM0101X
TaxonomyMaternal & Fetal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: GRETCHEN AMSTUTZ
Title or Position: CREDENTIALING MANAGER
Credential:
Phone: 505-764-9535