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Individual

ALAN ZELICOFF

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
4316 CARLISLE BLVD NE, STE C, ALBUQUERQUE, NM 87107-4829
(505) 888-1075
(505) 888-1082
Mailing address
4316 CARLISLE BLVD NE, STE C, ALBUQUERQUE, NM 87107-4829
(505) 888-1075
(505) 888-1082

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
81-348
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1043376346
GROUP NPI
NM
05
53234774
NM
Enumeration date
02/02/2010
Last updated
12/07/2010
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