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General NPI Number Information
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NPI Number | 1871237396
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Entity Type | Individual
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Provider Name | SANTHOSHI KOTRIKE DO
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Gender | Female
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Dates
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Enumeration Date | 04/21/2022
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Last Update Date | 11/15/2024
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Provider Practice Location Address
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Address Line | MSC10 5620 1 UNIVERSITY OF NEW MEXICO
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City | ALBUQUERQUE
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State | NM
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Zip | 87131
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Country | US
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Telephone | 505-272-3160
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Fax | 505-272-9427
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Provider Business Mailing Address
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Address Line | 700 MULLICA HILL RD
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City | MULLICA HILL
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State | NJ
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Zip | 08062-4413
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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 | RS2023-1152
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License Number State | NM
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