Provider Demographics
NPI:1750442133
Name:ALBUQUERQUE SURGICAL CONSULTANTS PC
Entity Type:Organization
Organization Name:ALBUQUERQUE SURGICAL CONSULTANTS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:
Authorized Official - Last Name:CARISTO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:505-224-7874
Mailing Address - Street 1:201 CEDAR ST SE STE 304
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87106-4932
Mailing Address - Country:US
Mailing Address - Phone:505-224-7874
Mailing Address - Fax:505-224-7559
Practice Address - Street 1:201 CEDAR ST SE STE 304
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87106-4932
Practice Address - Country:US
Practice Address - Phone:505-224-7874
Practice Address - Fax:505-224-7559
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty