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General NPI Number Information
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NPI Number | 1508529785
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Entity Type | Individual
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Provider Name | SAGELINE LABAZE
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Gender | Female
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Dates
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Enumeration Date | 10/14/2021
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Last Update Date | 07/01/2025
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Provider Practice Location Address
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Address Line | MSC10 5000 1 UNIVERSITY OF NEW MEXICO
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City | ALBUQUERQUE
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State | NM
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Zip | 87131-2719
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Country | US
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Telephone | 505-272-3414
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Fax |
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Provider Business Mailing Address
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Address Line | 2211 LOMAS BLVD NE
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City | ALBUQUERQUE
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State | NM
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Zip | 87106-2719
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number | RS2023-1224
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License Number State | NM
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