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Organization

BEVERLY A. PUCKA, MD P.C.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
BEVERLY A PUCKA M.D. (OWNER)
(505) 842-8741
Entity
Organization

Contact information

Practice address
8120 CONSTITUTION PL NE, SUITE 220, ALBUQUERQUE, NM 87110-7654
(505) 842-8741
(505) 842-8190
Mailing address
8120 CONSTITUTION PL NE, SUITE 220, ALBUQUERQUE, NM 87110-7654
(505) 842-8741
(505) 842-8190

Taxonomy

Speciality
Code
Description
License number
State
207VG0400X
Gynecology Physician
Primary
86-107
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
37325
NM
Enumeration date
01/29/2009
Last updated
01/29/2009
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