Provider Demographics
NPI:1942687876
Name:ALBUQUERQUE PEDIATRIC ASSOCIATES, LTD.
Entity Type:Organization
Organization Name:ALBUQUERQUE PEDIATRIC ASSOCIATES, LTD.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:TURNEY
Authorized Official - Suffix:
Authorized Official - Credentials:
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:2015-04-29
Last Update Date:2015-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM74-65208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM1568462836OtherNPI
NM1871593129OtherNPI
NM1841290533OtherNPI
NM1013917384OtherNPI
NM1477553741OtherNPI