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General NPI Number Information
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NPI Number | 1558550657
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Entity Type | Organization
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Legal Business Name | LISA J PERKOWSKI MD PC
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Dates
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Enumeration Date | 10/15/2007
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Last Update Date | 10/15/2007
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Provider Practice Location Address
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Address Line | 2409 W PIERCE ST
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City | CARLSBAD
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State | NM
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Zip | 88220-3513
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Country | US
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Telephone | 505-887-1282
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Fax | 505-885-9923
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Provider Business Mailing Address
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Address Line | 2409 W PIERCE ST
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City | CARLSBAD
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State | NM
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Zip | 88220-3513
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Country | US
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Telephone | 505-887-1282
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Fax | 505-885-9923
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Authorized Official
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Title or Position | OWNER/PHYSICIAN
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Name | DR. LISA J PERKOWSKI
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Credential | MD
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Telephone | 505-887-1282
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207K00000X
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Taxonomy Name | Allergy & Immunology Physician
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License Number | 89276
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License Number State | NM
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