Northern NM Vascular Lab

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

NORTHERN NM VASCULAR LAB

Practice address

7555 Enchanted HLS Dr NE
Suite 210
Rio Rancho, NM 87144-8625

Phone

(505) 771-9001

Fax

(505) 771-7074

NPI assigned

Oct 23, 2009

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) 982-3814

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

Northern New Mexico Vascular Lab2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Paul E Walsky

  • Clinical Medical Laboratory
  • Santa Fe, NM
  • NPI 1245387158
  NPD tax ID

Locations

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

{
    "created_epoch": "1256256000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1256256000000",
    "number": "1659607760",
    "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": "505-982-3814",
            "fax_number": "505-983-1899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7555 ENCHANTED HLS DR NE",
            "address_2": "SUITE 210",
            "city": "RIO RANCHO",
            "state": "NM",
            "postal_code": "871448625",
            "telephone_number": "505-771-9001",
            "fax_number": "505-771-7074"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHERN NM VASCULAR LAB",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-10-23",
        "last_updated": "2009-10-23",
        "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": "505-982-3814",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "NM",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "54528",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Eden Nolan
• Bryan D Norman, LCSW
• Doreen Norman
• Janice Norman, BMS
• Katie Norris, BMS AND CSW
• Northland Hearing Centers Inc
• Chelsea Northup, RN
• Ryan Matthew Novak
• Themis Ntalageorgos, M. D.
• Numinous Counseling and Wellness, LLC

• Clinical Medical Laboratory in Rio Rancho, NM
• Providers in Rio Rancho, 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 23, 2009; 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.