Provider Demographics
NPI:1346378080
Name:FURGANG, NANCIE (MA,OTR)
Entity Type:Individual
Prefix:
First Name:NANCIE
Middle Name:
Last Name:FURGANG
Suffix:
Gender:F
Credentials:MA,OTR
Other - Prefix:
Other - First Name:NANCY
Other - Middle Name:
Other - Last Name:FURGANG
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MA, OTR
Mailing Address - Street 1:933 BRADBURY DR SE
Mailing Address - Street 2:SUITE 2222
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87106-4374
Mailing Address - Country:US
Mailing Address - Phone:505-272-3120
Mailing Address - Fax:505-272-8060
Practice Address - Street 1:2300 MENAUL BLVD NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87107-1851
Practice Address - Country:US
Practice Address - Phone:505-272-6990
Practice Address - Fax:505-272-4539
Is Sole Proprietor?:No
Enumeration Date:2007-03-02
Last Update Date:2012-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM2028225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist