Basic Information
| Provider Information | |||||||||
| NPI: | 1255778478 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ABATE | ||||||||
| FirstName: | CARINA | ||||||||
| MiddleName: | SOFIA | ||||||||
| NamePrefix: | MS. | ||||||||
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| Credential: | L.M.T. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 213 W ALICANTE RD | ||||||||
| Address2: | |||||||||
| City: | SANTA FE | ||||||||
| State: | NM | ||||||||
| PostalCode: | 875054603 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5059882449 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 1348 PACHECO ST | ||||||||
| Address2: | #206 | ||||||||
| City: | SANTA FE | ||||||||
| State: | NM | ||||||||
| PostalCode: | 875054222 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5059882449 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/29/2013 | ||||||||
| LastUpdateDate: | 05/29/2013 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225700000X | 7170 | NM | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Massage Therapist |
No ID Information.