Sylvia Cruz Bencomo
Individual provider Active NPI Specialist · Los Ranchos, NM
NPI 1629415575 · NPPES record last updated Jun 2, 2013
Key facts
- NPI
- 1629415575
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Specialist 174400000X
- License
- 1039 (NM)
- Practice address
- 8318 4TH St NW
Los Ranchos, NM 87114-1017 - Phone
- (505) 933-1069
- NPI assigned
- Jun 2, 2013
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 1039 | NM | Yes |
Addresses
Primary practice location
8318 4TH St NW
Los Ranchos, NM 87114-1017
Mailing address
6428 Kochis Rd NW
Albuquerque, NM 87120-3206
Phone (505) 899-1970
Other providers in Los Ranchos, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 2, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.