Provider Demographics
NPI:1396845947
Name:SIRWINSKI, NEAL PAUL (DOM)
Entity Type:Individual
Prefix:DR
First Name:NEAL
Middle Name:PAUL
Last Name:SIRWINSKI
Suffix:
Gender:M
Credentials:DOM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3816 CARLISLE BLVD NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87107-4547
Mailing Address - Country:US
Mailing Address - Phone:505-837-2335
Mailing Address - Fax:
Practice Address - Street 1:3816 CARLISLE BLVD NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87107-4547
Practice Address - Country:US
Practice Address - Phone:505-837-2335
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM126171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist