Provider Demographics
NPI:1508930546
Name:ALBUQUERQUE PEDIATRIC ASSOCIATES, LTD.
Entity Type:Organization
Organization Name:ALBUQUERQUE PEDIATRIC ASSOCIATES, LTD.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:O
Authorized Official - Last Name:MOSMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:505-293-1333
Mailing Address - Street 1:8308 CONSTITUTION PL NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87110-7637
Mailing Address - Country:US
Mailing Address - Phone:505-293-1333
Mailing Address - Fax:505-293-4357
Practice Address - Street 1:8308 CONSTITUTION PL NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87110-7637
Practice Address - Country:US
Practice Address - Phone:505-293-1333
Practice Address - Fax:505-293-4357
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care