Provider Demographics
NPI:1912591314
Name:NEUROLOGY SPECIALISTS OF ALBUQUERQUE, LLC
Entity Type:Organization
Organization Name:NEUROLOGY SPECIALISTS OF ALBUQUERQUE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:VERONICA
Authorized Official - Middle Name:VANESSA
Authorized Official - Last Name:OWNBEY
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:505-554-6549
Mailing Address - Street 1:2440 LOUISIANA BLVD NE STE 200
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87110-4400
Mailing Address - Country:US
Mailing Address - Phone:505-389-1991
Mailing Address - Fax:505-389-1989
Practice Address - Street 1:2440 LOUISIANA BLVD NE STE 200
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87110-4400
Practice Address - Country:US
Practice Address - Phone:505-389-1991
Practice Address - Fax:505-389-1989
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-25
Last Update Date:2023-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty