Healthcare Provider Details

I. General information

NPI: 1477553741
Provider Name (Legal Business Name): KATHLEEN JOAN DARRIGO M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 07/28/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8308 CONSTITUTION PL NE
ALBUQUERQUE NM
87110-7637
US

IV. Provider business mailing address

8308 CONSTITUTION PL NE
ALBUQUERQUE NM
87110-7637
US

V. Phone/Fax

Practice location:
  • Phone: 505-293-1333
  • Fax: 505-293-4357
Mailing address:
  • Phone: 505-293-1333
  • Fax: 505-293-4357

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number94-35
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: