Organization
ADLER MEDICAL LLC
Active
Other names
Adler Medical Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ETHAN ADLER FNP-BC (OWNER/PROVIDER)
(505) 506-4445
Entity
Organization
Contact information
Practice address
4241 MONTGOMERY BLVD NE, ALBUQUERQUE, NM 87109-1081
(505) 883-8099
(505) 833-8649
Mailing address
4241 MONTGOMERY BLVD NE, ALBUQUERQUE, NM 87109-1081
(505) 883-8099
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
CNP-02214
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
16984064
MEDICARE NBR 311347YL1G
NM
05
—
16984064
—
NM
Enumeration date
06/30/2015
Last updated
07/07/2020
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