Individual
DR. SANDRA ROSANNA ROSENFELD-O'TOOL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2400 TUCKER NE, ALBUQUERQUE, NM 87131-1009
(505) 272-1734
Mailing address
800 BRADBURY DR SE STE 116, ALBUQUERQUE, NM 87106-4310
(505) 272-1476
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
036113944
IL
207Q00000X
Family Medicine Physician
32995
IA
207Q00000X
Family Medicine Physician
Primary
MD2018-0740
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0080200
—
IA
01
—
1238353
CSA #
IA
01
—
13238
MEDICARE PART B GROUP
IA
01
—
16-1801
FQHC GROUP UGS
IA
01
—
16D0387805
CLIA
IA
01
—
31319
BC/BS IA INDIVIDUAL
IA
05
—
421060724002
—
IL
01
—
71503
WELLMARK BCBS
IA
Enumeration date
04/19/2007
Last updated
10/14/2024
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