Basic Information
Provider Information
NPI: 1356339600
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: RESCH
FirstName: NINA
MiddleName: DESAI
NamePrefix:  
NameSuffix:  
Credential: PHARM.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1501 SAN PEDRO DR SE # 119
Address2:  
City: ALBUQUERQUE
State: NM
PostalCode: 871085153
CountryCode: US
TelephoneNumber: 5052651711
FaxNumber: 5052562789
Practice Location
Address1: 1501 SAN PEDRO DR SE
Address2:  
City: ALBUQUERQUE
State: NM
PostalCode: 871085153
CountryCode: US
TelephoneNumber: 5052651711
FaxNumber: 5052562789
Other Information
ProviderEnumerationDate: 10/11/2005
LastUpdateDate: 07/12/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
183500000X5847NMY Pharmacy Service ProvidersPharmacist 

No ID Information.


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