Healthcare Provider Details

I. General information

NPI: 1801941737
Provider Name (Legal Business Name): MARK A ARCURI PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/23/2007
Last Update Date: 10/04/2026
Certification Date: 10/04/2026
Deactivation Date: 01/08/2013
Reactivation Date: 01/13/2021

III. Provider practice location address

4250 CERRILLOS RD # 29926
SANTA FE NM
87507-4697
US

IV. Provider business mailing address

4250 CERRILLOS RD # 29926
SANTA FE NM
87507-4697
US

V. Phone/Fax

Practice location:
  • Phone: 505-629-0821
  • Fax: 430-443-0055
Mailing address:
  • Phone: 505-629-0821
  • Fax: 573-251-0237

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberPA9601
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: