Provider Demographics
NPI:1760823462
Name:OCHOA, MARISA ROSALINDA (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:MARISA
Middle Name:ROSALINDA
Last Name:OCHOA
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:805 MARCELLA ST NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87123-1240
Mailing Address - Country:US
Mailing Address - Phone:505-917-8758
Mailing Address - Fax:
Practice Address - Street 1:4700 4TH ST NW
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87107-3902
Practice Address - Country:US
Practice Address - Phone:505-344-1390
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-10
Last Update Date:2013-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMRP00007982183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist