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NPI Code Detail

MEDICARE: GINNY ROSSBERG MOTR/L

MEDICARE:   GINNY  ROSSBERG  MOTR/L
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
1225X00000XOccupational TherapistOT2925NM
2225X00000XOccupational Therapist2925NM

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 : 1326309741
Entity Type Code : Individual
Provider Name (Legal Business Name) : GINNY ROSSBERG MOTR/L
Provider Business Mailing Address
First Line : 6301 FOREST HILLS DR NE
Second Line :
City : ALBUQUERQUE
State : NM
Zip : 87109-4137
Country : US
Telephone Number : 505-823-8345
Fax Number : 505-823-8355
Provider Business Practice Location Address
First Line : 1408 LOMAS BLVD NW
Second Line :
City : ALBUQUERQUE
State : NM
Zip : 87104-1236
Country : US
Telephone Number : 505-264-6752
Fax Number : 949-404-8551
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/01/2012
Last Update Date : 10/03/2019

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Directions to “ GINNY ROSSBERG MOTR/L” Practice Location

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