| Sandia Neuropsychology Llc | |
|
3400 Constitution Ne Albuquerque NM 87106 | |
| (505) 270-4242 | |
| (505) 288-3579 |
| Full Name | Sandia Neuropsychology Llc |
|---|---|
| Speciality | Clinical Neuropsychologist |
| Location | 3400 Constitution Ne, Albuquerque, New Mexico |
| Authorized Official Name and Position | Robert J Thoma (OWNER) |
| Authorized Official Contact | 5052704242 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sandia Neuropsychology Llc 3400 Constitution Ne Albuquerque NM 87106 Ph: (505) 270-4242 | Sandia Neuropsychology Llc 3400 Constitution Ne Albuquerque NM 87106 Ph: (505) 270-4242 |
| NPI Number | 1861824898 |
|---|---|
| Provider Enumeration Date | 08/01/2013 |
| Last Update Date | 08/01/2013 |
| Medicare PECOS PAC ID | 5092930271 |
|---|---|
| Medicare Enrollment ID | O20140701001819 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861824898 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103G00000X | Clinical Neuropsychologist | 0796 (New Mexico) | Primary |
| Provider Name | Robert J. Thoma |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1649286253 PECOS PAC ID: 2860590809 Enrollment ID: I20070614000361 |
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