Organization · NPI-2

Beverly A. Pucka, MD P.C.

Obstetrics & Gynecology, Gynecology · Albuquerque, NM

NPI number1235377268
StatusActive
Last updated in NPPESJan 29, 2009

Details

NPI
1235377268
Entity type
Organization (NPI-2)
Legal business name
Beverly A. Pucka, MD P.C.
Organization subpart
No
Enumeration date
Jan 29, 2009
Last updated
Jan 29, 2009

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207VG0400X Obstetrics & Gynecology, Gynecology86-107NMYes

Practice location

8120 Constitution Pl Ne
Suite 220
Albuquerque, NM 87110-7654

Phone 505-842-8741 · Fax 505-842-8190

Mailing address

8120 Constitution Pl Ne
Suite 220
Albuquerque, NM 87110-7654

Phone 505-842-8741 · Fax 505-842-8190

Authorized official

Beverly A Pucka
Owner
5058428741

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