Individual
LARA MARIE PATRIQUIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
4411 THE 25 WAY NE, #150, ALBUQUERQUE, NM 87109-5857
(505) 332-6900
(505) 332-6921
Mailing address
4411 THE 25 WAY NE, #150, ALBUQUERQUE, NM 87109-5857
(505) 332-6900
(505) 332-6921
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
MD20040120
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
45152381
—
NM
05
—
880676
—
AZ
Enumeration date
03/07/2006
Last updated
04/26/2023
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