Provider Demographics
NPI:1922208230
Name:LUCIA CIES, M.D., P.C.
Entity Type:Organization
Organization Name:LUCIA CIES, M.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:
Authorized Official - Last Name:GAGAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:505-983-1213
Mailing Address - Street 1:435 SAINT MICHAELS DR STE B201
Mailing Address - Street 2:
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87505-7681
Mailing Address - Country:US
Mailing Address - Phone:505-983-1213
Mailing Address - Fax:505-983-9546
Practice Address - Street 1:435 SAINT MICHAELS DR STE B201
Practice Address - Street 2:
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87505-7681
Practice Address - Country:US
Practice Address - Phone:505-983-1213
Practice Address - Fax:505-983-9546
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-24
Last Update Date:2007-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NMC97657Medicare UPIN