Healthcare Provider Details

I. General information

NPI: 1275604431
Provider Name (Legal Business Name): REHABILITATION MEDICINE ASSOCIATES OF NORTHERN NEW MEXICO PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/10/2006
Last Update Date: 12/27/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1691 GALISTEO ST STE E
SANTA FE NM
87505-4781
US

IV. Provider business mailing address

1691 GALISTEO ST STE E
SANTA FE NM
87505-4781
US

V. Phone/Fax

Practice location:
  • Phone: 505-983-2233
  • Fax: 505-983-2290
Mailing address:
  • Phone: 505-983-2233
  • Fax: 505-983-2290

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License Number94-387
License Number StateNM

VIII. Authorized Official

Name: DR. BELYN SCHWARTZ
Title or Position: PRESIDENT
Credential: M.D.
Phone: 505-983-2233