| New Mexico Clinical Research & Osteoporosis Center, Inc | |
|
300 Oak St Ne Albuquerque NM 87106-4725 | |
| (505) 855-5525 | |
| (505) 884-4006 |
| Full Name | New Mexico Clinical Research & Osteoporosis Center, Inc |
|---|---|
| Speciality | Internal Medicine |
| Location | 300 Oak St Ne, Albuquerque, New Mexico |
| Authorized Official Name and Position | E Michael Lewiecki (OWNER/PRESIDENT) |
| Authorized Official Contact | 5058555525 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| New Mexico Clinical Research & Osteoporosis Center, Inc 300 Oak St Ne Albuquerque NM 87106-4725 Ph: (505) 855-5525 | New Mexico Clinical Research & Osteoporosis Center, Inc 300 Oak St Ne Albuquerque NM 87106-4725 Ph: (505) 855-5525 |
| NPI Number | 1871584730 |
|---|---|
| Provider Enumeration Date | 10/31/2005 |
| Last Update Date | 11/20/2007 |
| Medicare PECOS PAC ID | 7113110750 |
|---|---|
| Medicare Enrollment ID | O20101015000099 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871584730 | NPI | - | NPPES |
| 000Z5691 | Medicaid | NM |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207QA0505X | Family Medicine - Adult Medicine | (* (Not Available)) | Secondary |
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Edward Michael Lewiecki |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1861441735 PECOS PAC ID: 9638362270 Enrollment ID: I20101015000213 |
| Provider Name | Lance A. Rudolph |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1376502997 PECOS PAC ID: 8729271366 Enrollment ID: I20101015000233 |
| Provider Name | Sarah Erb |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023516291 PECOS PAC ID: 5698036705 Enrollment ID: I20180307000586 |
| Provider Name | Desiree Sanchez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316569114 PECOS PAC ID: 6103246087 Enrollment ID: I20201014002338 |
| Provider Name | Cierra Dorado |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386251957 PECOS PAC ID: 0648681783 Enrollment ID: I20201123000575 |
| Provider Name | Pamela L Phillips |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407518863 PECOS PAC ID: 7911396783 Enrollment ID: I20211116002938 |
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