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1477553741

NPI Code Detail

MEDICARE: KATHLEEN JOAN DARRIGO M.D.

MEDICARE: KATHLEEN JOAN DARRIGO 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
1	208000000X	Pediatrics Physician	94-35	NM

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	007	OTHER	NM	CIMARRON HEALTH PLAN
2	NM014467	OTHER	NM	BCBS PROVIDER NUMBER
3	38795	OTHER	NM	PHP PROVIDER NUMBER

General Provider Information

NPI Number	:	1477553741
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATHLEEN JOAN DARRIGO M.D.

Provider Business Mailing Address
First Line	:	8308 CONSTITUTION PL NE
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87110-7637
Country	:	US
Telephone Number	:	505-293-1333
Fax Number	:	505-293-4357

Provider Business Practice Location Address
First Line	:	8308 CONSTITUTION PL NE
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87110-7637
Country	:	US
Telephone Number	:	505-293-1333
Fax Number	:	505-293-4357

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/28/2005
Last Update Date	:	07/08/2007

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Directions to “ KATHLEEN JOAN DARRIGO M.D.” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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