| Marjama Inc | |
|
7000 Jefferson St Ne Albuquerque NM 87109-4313 | |
| (505) 797-3771 | |
| Not Available |
| Full Name | Marjama Inc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 7000 Jefferson St Ne, Albuquerque, New Mexico |
| Authorized Official Name and Position | Jill M Marjama Lyons (OWNER) |
| Authorized Official Contact | 5057973771 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Marjama Inc Po Box 94390 Albuquerque NM 87199-4390 Ph: (505) 797-3771 | Marjama Inc 7000 Jefferson St Ne Albuquerque NM 87109-4313 Ph: (505) 797-3771 |
| NPI Number | 1821180936 |
|---|---|
| Provider Enumeration Date | 09/28/2006 |
| Last Update Date | 02/24/2012 |
| Medicare PECOS PAC ID | 8022097120 |
|---|---|
| Medicare Enrollment ID | O20040714000167 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821180936 | NPI | - | NPPES |
| 18879 | Medicaid | NM |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | 94-319 (New Mexico) | Primary |
| Provider Name | Jill M Marjama-lyons |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1366534570 PECOS PAC ID: 2567441660 Enrollment ID: I20040714000257 |
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