Pamela O Black Md Pa

NPI 1093752545 - Physical Medicine & Rehabilitation - 208100000X

NPI Details
NPI 1093752545
Enumeration Date 06/01/2006
Last Updated 12/13/2013
Entity Type Healthcare Provider
Active Over 10 years ago
Authorized Information
Name TIMOTHY TIMOTHY
Position CEO
Phone (505) 343-1711
Fax (505) 343-1862
Practice Location
3820 COMMONS AVE NE
ALBUQUERQUE NM, 87109-5831, US
Phone (505) 343-1711
Fax (505) 343-1862
Business Location
PO BOX 25206
ALBUQUERQUE NM, 87125-0206, US
Phone (505) 343-1711
Fax (505) 343-1862
Toxanomy
Taxonomy Code 208100000X
License State
License Number
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According to our database, Pamela O Black Md Pa NPI is 1093752545, taxonomy code is 208100000X Pamela O Black Md Pa physically located at 3820 Commons Ave Ne, Albuquerque NM, 87109-5831. NPI Number 1033115704 has the healthcare provider type.

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1093752545 NPI number is provided on an as is basis without warranty of any kind. 1093752545 is maintained by the National Plan & Provider Enumeration System. The contents of Pamela O Black Md Pa are for informational purposes only.