Healthcare Provider Details

I. General information

NPI: 1578604807
Provider Name (Legal Business Name): NATIONAL CLINICAL TECHNOLOGY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/09/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10400 ACADEMY RD NE SUITE #340
ALBUQUERQUE NM
87111-1229
US

IV. Provider business mailing address

10400 ACADEMY RD NE SUITE #340
ALBUQUERQUE NM
87111-1229
US

V. Phone/Fax

Practice location:
  • Phone: 505-298-1558
  • Fax: 505-298-7012
Mailing address:
  • Phone: 505-298-1558
  • Fax: 505-298-7012

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number2214
License Number StateNM

VIII. Authorized Official

Name: MS. CATHY KARNIS
Title or Position: BILLING DIRECTOR
Credential:
Phone: 505-298-1558