SYNERGY WELLNESS CENTER LLC NPI 1154595825

NPI Information

NPI: 1154595825
Provider Name: SYNERGY WELLNESS CENTER LLC

Former Legal Business Name: HIGH DESERT FAMILY FOOT CARE

Classification: Clinic/Center - 261QP1100X
Entity Type: Organization

Specialization: Podiatric

Address:
4801 LANG AVE NE
SUITE 110
ALBUQUERQUE, NM
ZIP 87109
Phone: (505) 892-9700
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SYNERGY WELLNESS CENTER LLC is a podiatric clinic center in Albuquerque, NM. SYNERGY WELLNESS CENTER LLC NPI is 1154595825. The provider is registered as an organization entity type.
The provider Former Legal Business Name Is High Desert Family Foot Care.

The provider's business location address is:

4801 LANG AVE NE
SUITE 110
ALBUQUERQUE, NM
ZIP 87109-474
Phone: (505) 892-9700
Fax: (505) 892-1210

The provider's authorized official is Gloria Isabel Gerstner .
The authorized official title is Ceo/physician and has the following contact phone number (505) 892-9700.

The enumeration date for this NPI number is 4/14/2008 and was last updated on 5/6/2013.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QP1100X	Clinic/Center	Podiatric	307	NEW MEXICO	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State
1	07835761	MEDICAID	NEW MEXICO
2	6248950001	MEDICARE NSC
3	NMB2071	MEDICARE PIN	NEW MEXICO
4	71889	MEDICARE UPIN	NEW MEXICO

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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