Active NPI
Mariela Cisco
- Registered Dietitian
- Albuquerque, NM
National Provider Identifier
1851890495
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 723974
- Practice address
- 801 Vassar Dr NE
Albuquerque, NM 87106-2725 - Phone
- (505) 248-7658
- Fax
- (505) 248-7698
- NPI assigned
- Feb 9, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 723974 | IL | Primary |
Addresses
Primary practice location
801 Vassar Dr NE
Albuquerque, NM 87106-2725
Mailing address
801 Vassar Dr NE
Albuquerque, NM 87106-2725
Phone (505) 248-7658
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 723974 | IL | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1518134400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1518134400000",
"number": "1851890495",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "801 VASSAR DR NE",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871062725",
"telephone_number": "505-248-7658",
"fax_number": "505-248-7698"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "801 VASSAR DR NE",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871062725",
"telephone_number": "505-248-7658",
"fax_number": "505-248-7698"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CISCO",
"first_name": "MARIELA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-02-09",
"last_updated": "2018-02-09",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "IL",
"license": "723974",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Albuquerque, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.