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General NPI Number Information
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NPI Number | 1043407075
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Entity Type | Organization
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Legal Business Name | NEUROSENSORY ALBUQUERQUE
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Dates
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Enumeration Date | 10/03/2007
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Last Update Date | 10/03/2007
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Provider Practice Location Address
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Address Line | 10601 LOMAS BLVD NE SUITE 105
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City | ALBUQUERQUE
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State | NM
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Zip | 87112-5470
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Country | US
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Telephone | 505-296-0330
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Fax | 505-292-4145
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Provider Business Mailing Address
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Address Line | 10601 LOMAS BLVD NE SUITE 105
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City | ALBUQUERQUE
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State | NM
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Zip | 87112-5470
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Country | US
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Telephone | 505-296-0330
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Fax | 505-292-4145
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Authorized Official
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Title or Position | CHAIRMAN
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Name | MRS. BEVERLY A RAMSEY
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Credential |
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Telephone | 505-296-0330
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number | FA0073956
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License Number State | NM
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