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NPI Code Detail

MEDICARE: JENNIFER COMO M.D.

MEDICARE: JENNIFER COMO M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine Physician98-242NM

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1003914300
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENNIFER COMO M.D.
Provider Business Mailing Address
First Line : 12127 HWY 14 N STE 5B
Second Line :
City : CEDAR CREST
State : NM
Zip : 87008-9461
Country : US
Telephone Number : 505-281-5180
Fax Number : 505-281-5320
Provider Business Practice Location Address
First Line : 1108 W US ROUTE 66
Second Line :
City : MORIARTY
State : NM
Zip : 87035-1006
Country : US
Telephone Number : 505-832-4434
Fax Number : 505-832-5024
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/20/2006
Last Update Date : 12/13/2013

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Directions to “ JENNIFER COMO M.D.” Practice Location

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