Individual
ELENI GIANACAKES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
6100 PAN AMERICAN FREEWAY, STE 390, ALBUQUERQUE, NM 87109-3401
(505) 823-8599
Mailing address
PO BOX 26666, PHS PROVIDER ENROLLMENT, ALBUQUERQUE, NM 87125-6666
(505) 923-6770
(505) 923-5354
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD2018-0242
NM
390200000X
Student in an Organized Health Care Education/Training Program
PG173661
OR
Other
Enumeration date
05/21/2015
Last updated
07/09/2018
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