Provider Demographics
NPI:1275604431
Name:REHABILITATION MEDICINE ASSOCIATES OF NORTHERN NEW MEXICO PC
Entity Type:Organization
Organization Name:REHABILITATION MEDICINE ASSOCIATES OF NORTHERN NEW MEXICO PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BELYN
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHWARTZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:505-983-2233
Mailing Address - Street 1:1691 GALISTEO ST STE E
Mailing Address - Street 2:
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87505-4781
Mailing Address - Country:US
Mailing Address - Phone:505-983-2233
Mailing Address - Fax:505-983-2290
Practice Address - Street 1:1691 GALISTEO ST STE E
Practice Address - Street 2:
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87505-4781
Practice Address - Country:US
Practice Address - Phone:505-983-2233
Practice Address - Fax:505-983-2290
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-10
Last Update Date:2007-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM94-387225400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation PractitionerGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM00NM009445OtherBCBS
NM26049Medicaid
NM00NM009445OtherBCBS
NM26049Medicaid