JOURNEY PEDIATRICS NPI 1205205630

NPI Information

JOURNEY PEDIATRICS is a primary care clinic center in Albuquerque, NM. JOURNEY PEDIATRICS NPI is 1205205630. The provider is registered as an organization entity type.

The provider's business location address is:

8308 CONSTITUTION PL NE
ALBUQUERQUE, NM
ZIP 87110
Phone: (505) 883-9570
Fax: (505) 883-4163

The provider's authorized official is Alwyn Koil .
The authorized official title is Owner and has the following contact phone number (505) 463-6618.

The CLIA number assigned to this NPI record is 32D2283387 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 9/16/2015 and was last updated on 5/15/2018.

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:

Other Identifiers

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

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