Provider Demographics
NPI:1265860134
Name:JUMISKO, VIRPI (DOM)
Entity Type:Individual
Prefix:DR
First Name:VIRPI
Middle Name:
Last Name:JUMISKO
Suffix:
Gender:F
Credentials:DOM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6217 ANTIGUA ST NE
Mailing Address - Street 2:APT. A
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87111-7029
Mailing Address - Country:US
Mailing Address - Phone:516-978-3210
Mailing Address - Fax:
Practice Address - Street 1:5520 WYOMING BLVD NE
Practice Address - Street 2:210
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87109-3238
Practice Address - Country:US
Practice Address - Phone:505-358-1989
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-31
Last Update Date:2013-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM1113171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist