Provider Demographics
NPI:1093986226
Name:HAND AND UPPER EXTREMITY
Entity Type:Organization
Organization Name:HAND AND UPPER EXTREMITY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:
Authorized Official - Last Name:KAMINS
Authorized Official - Suffix:
Authorized Official - Credentials:OTR
Authorized Official - Phone:505-466-4263
Mailing Address - Street 1:34 ASTER WAY
Mailing Address - Street 2:
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87508-2295
Mailing Address - Country:US
Mailing Address - Phone:505-466-4263
Mailing Address - Fax:505-466-4263
Practice Address - Street 1:34 ASTER RD
Practice Address - Street 2:
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87508
Practice Address - Country:US
Practice Address - Phone:505-466-4263
Practice Address - Fax:505-466-4263
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-15
Last Update Date:2009-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM149225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHandGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM1195480001Medicare NSC