Individual
DR. THERESA MICHELLE GENOVESE ELLIOTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
4801 BECKNER RD LEVEL 1 POD 2, STE 1650, SANTA FE, NM 87507-0000
(505) 772-2000
(505) 983-5202
Mailing address
PO BOX 26666, PROVIDER ENROLLMENT, ALBUQUERQUE, NM 87125-6666
(505) 923-6770
(505) 923-5354
Taxonomy
Speciality
Code
Description
License number
State
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
Primary
99-206
NM
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
99206
NM
Other
Enumeration date
06/16/2006
Last updated
05/29/2025
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