Individual
MRS. SYLVIA CRUZ BENCOMO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
8318 4TH ST NW, LOS RANCHOS, NM 87114-1017
(505) 933-1069
Mailing address
6428 KOCHIS RD NW, ALBUQUERQUE, NM 87120-3206
(505) 899-1970
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
1039
NM
Other
Enumeration date
06/02/2013
Last updated
06/02/2013
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