Healthcare Provider Details

I. General information

NPI: 1417886474
Provider Name (Legal Business Name): MARY PATRICIA HAMZIK
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/15/2026
Last Update Date: 05/15/2026
Certification Date: 05/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

UNIVERSITY OF NEW MEXICO HEALTH SCIENCES CENTER DEPT OF PSYCHIATRY & BEHAVIORAL SCIENCES
ALBUQUERQUE NM
87131-0001
US

IV. Provider business mailing address

3421 MARK DR
BROADVIEW HTS OH
44147-2030
US

V. Phone/Fax

Practice location:
  • Phone: 505-272-2223
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: