Provider Demographics
NPI:1649785288
Name:ABUCEJO, ARMANDO SANCHEZ JR (AGACNP-BC)
Entity type:Individual
Prefix:
First Name:ARMANDO
Middle Name:SANCHEZ
Last Name:ABUCEJO
Suffix:JR
Gender:M
Credentials:AGACNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18012 N 34TH DR
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85053-1627
Mailing Address - Country:US
Mailing Address - Phone:623-734-5230
Mailing Address - Fax:
Practice Address - Street 1:18012 N 34TH DR
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85053-1627
Practice Address - Country:US
Practice Address - Phone:623-734-5230
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-12-05
Last Update Date:2017-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP10823363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner