Individual
MR. TIMOTHY D. KRENIK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
8210 LOUISIANA BLVD. NE, SUITE C, ALBUQUERQUE, NM 87113-1761
(505) 858-1222
(505) 858-1224
Mailing address
8210 LOUISIANA BLVD. NE, SUITE C, ALBUQUERQUE, NM 87113-1761
(505) 858-1222
(505) 858-1224
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA2003-0018
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
64782841
—
NM
Enumeration date
01/16/2006
Last updated
12/18/2009
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