Dr. Martin Nicholas Ancona
Psychologist Clinical Psychologist Prescribing (Medical)
320 Mccombs Rd Ste C
Chaparral
, New Mexico 88081-7937
Dr. Martin Nicholas Ancona
Psychologist Clinical Psychologist Prescribing (Medical)
320 Mccombs Rd Ste C
Chaparral
, New Mexico 88081-7937
(575) 882-5100
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About
Features
Specialties
- Psychologist
- Clinical Psychologist
- Prescribing (Medical)
Languages spoken
- English
Location
First Address
- Dr. Martin Nicholas Ancona
- 785 Anthony Drive
- Anthony, NM
- Zip : 88021-9747
- Phone : (575) 882-5100
Second Address
- Dr. Martin Nicholas Ancona
- 320 Mccombs Rd Ste C
- Chaparral, NM
- Zip : 88081-7937
- Fax : (575) 882-1151
- Phone : (575) 882-5100
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| N | 102L00000X | Psychologist | PY60201752 | WA |
| N | 103T00000X | Psychologist | PY60201752 | WA |
| N | 103G00000X | Clinical Psychologist | 1296 | NM |
| N | 103TC0700X | Clinical Psychologist | 1296 | NM |
| Y | 103TP0016X | Prescribing (Medical) | 0040C | NM |
National Provider Identifier
| NPI | 1003065749 |
|---|---|
| Provider Name | Dr. Martin Nicholas Ancona |
| First Address | Anthony, NM 88021-9747 |
| Second Address | Chaparral, NM 88081-7937 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 18/09/2008 |
| Last Update Date | 28/02/2017 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.