Healthcare Provider Details

I. General information

NPI: 1881666998
Provider Name (Legal Business Name): RADIOLOGY ASSOCIATES OF ALBUQUERQUE, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/02/2006
Last Update Date: 09/12/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4411 THE 25 WAY NE SUITE 150
ALBUQUERQUE NM
87109-5857
US

IV. Provider business mailing address

4411 THE 25 WAY NE SUITE 150
ALBUQUERQUE NM
87109-5857
US

V. Phone/Fax

Practice location:
  • Phone: 505-332-6900
  • Fax: 505-332-6921
Mailing address:
  • Phone: 505-332-6900
  • Fax: 505-332-6921

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number
License Number State

VIII. Authorized Official

Name: RHONDA MAYORGA
Title or Position: BILLING DIRECTOR
Credential:
Phone: 505-332-5827