Provider Demographics
NPI:1376133298
Name:SANCHEZ, ELIA F
Entity Type:Individual
Prefix:
First Name:ELIA
Middle Name:F
Last Name:SANCHEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:703 SOUTH CHRISTOPHER ROAD
Mailing Address - Street 2:
Mailing Address - City:BELEN
Mailing Address - State:NM
Mailing Address - Zip Code:87002
Mailing Address - Country:US
Mailing Address - Phone:505-864-7781
Mailing Address - Fax:505-864-3360
Practice Address - Street 1:703 SOUTH CHRISTOPHER ROAD
Practice Address - Street 2:
Practice Address - City:BELEN
Practice Address - State:NM
Practice Address - Zip Code:87002
Practice Address - Country:US
Practice Address - Phone:505-864-7781
Practice Address - Fax:505-864-3360
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-25
Last Update Date:2021-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center