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NPI Code Detail

MEDICARE: MS. EILEEN T SATURN LISW

MEDICARE: MS. EILEEN T SATURN LISW
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
11041C0700XClinical Social WorkerI3054NM

General Provider Information

NPI Number : 1083651459
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. EILEEN T SATURN LISW
Provider Business Mailing Address
First Line : 5115 GOLONDRINA NW
Second Line :
City : ALBUQUERQUE
State : NM
Zip : 87120-2037
Country : US
Telephone Number : 505-897-4102
Fax Number :
Provider Business Practice Location Address
First Line : 1010 LAS LOMAS RD NE
Second Line : SUITE 4
City : ALBUQUERQUE
State : NM
Zip : 87102-2634
Country : US
Telephone Number : 505-272-0061
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/02/2006
Last Update Date : 09/03/2008

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Directions to “ MS. EILEEN T SATURN LISW” Practice Location

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