| Sandra L. Montoya, Ph.d., Pc | |
|
3900 Juan Tabo Blvd Ne Suite 11 Albuquerque NM 87111-3984 | |
| (505) 275-6457 | |
| (505) 298-3939 |
| Full Name | Sandra L. Montoya, Ph.d., Pc |
|---|---|
| Speciality | Clinical Neuropsychologist |
| Location | 3900 Juan Tabo Blvd Ne, Albuquerque, New Mexico |
| Authorized Official Name and Position | Sandra Montoya (PRESIDENT) |
| Authorized Official Contact | 5052756457 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sandra L. Montoya, Ph.d., Pc 3900 Juan Tabo Blvd Ne Suite 11 Albuquerque NM 87111-3984 Ph: (505) 275-6457 | Sandra L. Montoya, Ph.d., Pc 3900 Juan Tabo Blvd Ne Suite 11 Albuquerque NM 87111-3984 Ph: (505) 275-6457 |
| NPI Number | 1902172281 |
|---|---|
| Provider Enumeration Date | 03/30/2012 |
| Last Update Date | 03/30/2012 |
| Medicare PECOS PAC ID | 1153583851 |
|---|---|
| Medicare Enrollment ID | O20120425000402 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902172281 | NPI | - | NPPES |
| 1447314091 | Other | NM | TYPE 1 NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103G00000X | Clinical Neuropsychologist | 640 (New Mexico) | Primary |
| Provider Name | Sandra L Montoya |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1447314091 PECOS PAC ID: 8224290929 Enrollment ID: I20120425000603 |
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