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General NPI Number Information
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NPI Number | 1780047621
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Entity Type | Organization
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Legal Business Name | ADVANCED ALLERGY ASSOCIATES OF NEW MEXICO INC
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Dates
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Enumeration Date | 03/29/2016
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Last Update Date | 08/22/2018
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Provider Practice Location Address
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Address Line | 5310 HOMESTEAD RD NE STE 201
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City | ALBUQUERQUE
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State | NM
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Zip | 87110-1524
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Country | US
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Telephone | 505-237-2574
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Fax |
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Provider Business Mailing Address
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Address Line | 5310 HOMESTEAD RD NE STE 201
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City | ALBUQUERQUE
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State | NM
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Zip | 87110-1524
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Country | US
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Telephone | 505-237-2574
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Fax |
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Authorized Official
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Title or Position | PRESIDENT OF OPERATIONS
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Name | RACHEL WESSELS
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Credential |
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Telephone | 505-237-2574
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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 |
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License Number State |
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