Provider Demographics
NPI:1669929485
Name:LAARAKKER, AVRA SOPHIA SASKIA (MD, MSC, BED)
Entity type:Individual
Prefix:DR
First Name:AVRA
Middle Name:SOPHIA SASKIA
Last Name:LAARAKKER
Suffix:
Gender:F
Credentials:MD, MSC, BED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:MSC PLASTIC SURGERY 1 UNIVERSITY OF NEW MEXICO
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87131-0001
Mailing Address - Country:US
Mailing Address - Phone:505-272-4264
Mailing Address - Fax:505-272-4264
Practice Address - Street 1:MSC PLASTIC SURGERY 1 UNIVERSITY OF NEW MEXICO
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87131-0001
Practice Address - Country:US
Practice Address - Phone:505-272-4264
Practice Address - Fax:505-272-4264
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-09
Last Update Date:2024-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMRTL208200000X
NC222273207T00000X
PAMD486085208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
No207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery