Northern New Mexico Vascular Lab Inc.

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

78-283 Issued in NM

Legal business name

NORTHERN NEW MEXICO VASCULAR LAB INC.

Practice address

531 Harkle Rd
Suite a-2
Santa Fe, NM 87505-4753

Phone

(505) 982-8482

Fax

(505) 983-1899

NPI assigned

Oct 27, 2010

Last updated

Oct 27, 2010By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Paul E. Walsky, M.D.

Title

Owner

Phone

(505) 982-8482

Specialties & licenses 1

Addresses

Other identifiers 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1288137600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1288137600000",
    "number": "1285934976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "531 HARKLE RD",
            "address_2": "SUITE A-2",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875054753",
            "telephone_number": "505-982-8482",
            "fax_number": "505-983-1899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "531 HARKLE RD",
            "address_2": "SUITE A-2",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875054753",
            "telephone_number": "505-982-8482",
            "fax_number": "505-983-1899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHERN NEW MEXICO VASCULAR LAB INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-27",
        "last_updated": "2010-10-27",
        "status": "A",
        "authorized_official_last_name": "WALSKY",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "E.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "505-982-8482",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "NM",
            "license": "78-283",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "54528",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Northern Counseling LLC
• Northern New Mexico Hearing and Balance Institute, LLC
• Northern New Mexico Neuropsychology LLC
• Northern New Mexico Periodontal Assoc.
• Northern New Mexico Podiatry Assoc.
• Northern NM Gastroenterology
• Northern NM Medical Management, LLC
• Frederic W Northern, PA-C
• Karan Northfield
• Northland Hearing Centers Inc (Advanced Hearing Clinics)

• Clinical Medical Laboratory in Santa Fe, NM
• Providers in Santa Fe, NM by specialty
• Clinical Medical Laboratory in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.