Healthcare Provider Details
I. General information
NPI: 1669487120
Provider Name (Legal Business Name): LAURA CAFFEY
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 07/30/2006
Last Update Date: 01/22/2025
Certification Date: 01/22/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3 RD AMBULATORY CARE CTR 2211 LOMAS BLVD. NE
ALBUQUERQUE NM
87131-0001
US
IV. Provider business mailing address
800 BRADBURY DR SE STE 116
ALBUQUERQUE NM
87106-4310
US
V. Phone/Fax
- Phone: 505-272-5551
- Fax:
- Phone: 505-272-1476
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2080P0214X |
| Taxonomy | Pediatric Pulmonology Physician |
| License Number | 98-23 |
| License Number State | NM |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: