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General NPI Number Information
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NPI Number | 1669551446
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Entity Type | Organization
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Legal Business Name | NEW MEXICO OSTEOPOROSIS INC.
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Dates
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Enumeration Date | 11/03/2006
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Last Update Date | 10/23/2012
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Provider Practice Location Address
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Address Line | 4300 SAN MATEO BLVD NE SUITE A-140
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City | ALBUQUERQUE
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State | NM
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Zip | 87110-1229
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Country | US
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Telephone | 505-888-0035
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Fax | 505-888-2002
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Provider Business Mailing Address
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Address Line | 4300 SAN MATEO BLVD NE SUITE A-140
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City | ALBUQUERQUE
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State | NM
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Zip | 87110-1229
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Country | US
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Telephone | 505-888-0035
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Fax | 505-888-2002
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Authorized Official
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Title or Position | BILLING SPECIALIST
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Name | MRS. STEPHANIE COSTALES
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Credential |
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Telephone | 505-888-0035
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 82161
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License Number State | NM
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