Sandia Neuropsychology Llc | |
3400 Constitution Ne Albuquerque NM 87106 | |
(505) 270-4242 | |
(505) 288-3579 |
Full Name | Sandia Neuropsychology Llc |
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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 |
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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 |
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Provider Enumeration Date | 08/01/2013 |
Last Update Date | 08/01/2013 |
Medicare PECOS PAC ID | 5092930271 |
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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 |
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Provider Type | Practitioner - Clinical Psychologist |
Provider Identifiers | NPI Number: 1649286253 PECOS PAC ID: 2860590809 Enrollment ID: I20070614000361 |
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