Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2082S0105X | Plastic Hand Surgeon | 9631 | NM |
NPI | 1053324244 |
---|---|
Provider Name | Neil T Chen |
First Address | Albuquerque, NM 87109 |
Second Address | Albuquerque, NM 87109 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/08/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
E51296 | (02) | |
NM004678 | BLUE CROSS BLUE SHIELD (01) | NM |