Individual
SAMUEL WILLIAM KOCHANSKY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
4401 MASRHEAD ST NE, SUITE 120, ALBUQUERQUE, NM 87109
(505) 243-7729
Mailing address
12231 ACADEMY RD NE, #301-229, ALBUQUERQUE, NM 87111-7236
(512) 415-9339
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
CRNA00897
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
77407821
—
NM
Enumeration date
08/09/2005
Last updated
07/08/2013
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