Healthcare Provider Details

I. General information

NPI: 1255364394
Provider Name (Legal Business Name): SONOGRAPHY SERVICES INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/09/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5621 PALOMINO DR NW
ALBUQUERQUE NM
87120-2237
US

IV. Provider business mailing address

PO BOX 66833
ALBUQUERQUE NM
87193-6833
US

V. Phone/Fax

Practice location:
  • Phone: 505-899-1447
  • Fax: 505-899-1447
Mailing address:
  • Phone: 505-899-1447
  • Fax: 505-899-1447

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246XS1301X
TaxonomySonography Specialist/Technologist Cardiovascular
License Number14339
License Number StateNM

VIII. Authorized Official

Name: ROSALIE GONZALES
Title or Position: PRESIDENT
Credential: RDCS
Phone: 505-899-1447