Organization
GENESIS ELDERCARE PHYSICIAN SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ERIC SHAPIRO (VICE PRESIDENT)
(410) 832-7790
Entity
Organization
Contact information
Practice address
7900 CONSTITUTION AVE NE, ALBUQUERQUE, NM 87110
(410) 769-7859
Mailing address
PO BOX 62946, BALTIMORE, MD 21264-2946
(410) 494-7607
(610) 925-7387
Taxonomy
Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
—
—
Other
Enumeration date
04/29/2016
Last updated
08/05/2019
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