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NPI Code Detail

MEDICARE: PAUL J AMEDURI MS, CMHC

MEDICARE: PAUL J AMEDURI MS, CMHC
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
1171M00000XCase Manager/Care CoordinatorNM

General Provider Information

NPI Number : 1942625470
Entity Type Code : Individual
Provider Name (Legal Business Name) : PAUL J AMEDURI MS, CMHC
Provider Business Mailing Address
First Line : PO BOX 28164
Second Line :
City : SANTA FE
State : NM
Zip : 87592-8164
Country : US
Telephone Number : 505-216-2727
Fax Number :
Provider Business Practice Location Address
First Line : 2600 THE AMERICAN RD SE STE 100
Second Line :
City : RIO RANCHO
State : NM
Zip : 87124-1858
Country : US
Telephone Number : 505-404-6907
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/20/2014
Last Update Date : 12/09/2025

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