Basic Information
| Provider Information | |||||||||
| NPI: | 1376565952 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | PERINATAL ASSOCIATES OF NEW MEXICO,LTD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 201 CEDAR SE | ||||||||
| Address2: | SUITE 405 | ||||||||
| City: | ALBUQUERQUE | ||||||||
| State: | NM | ||||||||
| PostalCode: | 87106 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5057649535 | ||||||||
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| Practice Location | |||||||||
| Address1: | 201 CEDAR SE | ||||||||
| Address2: | SUITE 405 | ||||||||
| City: | ALBUQUERQUE | ||||||||
| State: | NM | ||||||||
| PostalCode: | 87106 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5057649535 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/24/2006 | ||||||||
| LastUpdateDate: | 12/09/2021 | ||||||||
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| AuthorizedOfficialLastName: | AMSTUTZ | ||||||||
| AuthorizedOfficialFirstName: | GRETCHEN | ||||||||
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| AuthorizedOfficialTitleorPosition: | CREDENTIALING MANAGER | ||||||||
| AuthorizedOfficialTelephone: | 5057649535 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 12/09/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207VM0101X | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | Maternal & Fetal Medicine |
No ID Information.