Basic Information
| Provider Information | |||||||||
| NPI: | 1518264308 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | TSIGELNITSKIY | ||||||||
| FirstName: | ALEKSANDR | ||||||||
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| Mailing Information | |||||||||
| Address1: | 500 WALTER ST NE | ||||||||
| Address2: | SUITE 401 | ||||||||
| City: | ALBUQUERQUE | ||||||||
| State: | NM | ||||||||
| PostalCode: | 871022534 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5052623542 | ||||||||
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| Practice Location | |||||||||
| Address1: | 500 WALTER ST NE | ||||||||
| Address2: | SUITE 401 | ||||||||
| City: | ALBUQUERQUE | ||||||||
| State: | NM | ||||||||
| PostalCode: | 871022534 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5052623542 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 02/15/2011 | ||||||||
| LastUpdateDate: | 06/04/2015 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363L00000X | 1742 | NM | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
No ID Information.