Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RC0000X | Internist - Cardiovascular Disease | 228765 | NY |
Y | 207RC0001X | Clinical Cardiac Electrophysiologist | MD2009-0446 | NM |
NPI | 1245372366 |
---|---|
Provider Name | Dr. Jerry L. Arellano |
First Address | Albuquerque, NM 87198-8387 |
Second Address | Albuquerque, NM 87102-2512 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/02/2007 |
Last Update Date | 15/12/2021 |