Provider Demographics
NPI:1043407075
Name:NEUROSENSORY ALBUQUERQUE
Entity Type:Organization
Organization Name:NEUROSENSORY ALBUQUERQUE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHAIRMAN
Authorized Official - Prefix:MRS
Authorized Official - First Name:BEVERLY
Authorized Official - Middle Name:A
Authorized Official - Last Name:RAMSEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:505-296-0330
Mailing Address - Street 1:10601 LOMAS BLVD NE
Mailing Address - Street 2:SUITE 105
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87112-5470
Mailing Address - Country:US
Mailing Address - Phone:505-296-0330
Mailing Address - Fax:505-292-4145
Practice Address - Street 1:10601 LOMAS BLVD NE
Practice Address - Street 2:SUITE 105
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87112-5470
Practice Address - Country:US
Practice Address - Phone:505-296-0330
Practice Address - Fax:505-292-4145
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-03
Last Update Date:2007-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMFA0073956291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory