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Organization

ALBUQUERQUE CENTER FOR DERMATOLOGY, PA

Active
Other names
ABQ Center for Dermatology
Organization subpart
No

Provider details

NPI number
Authorized official
DR. VINCENT A MUSCARELLA M.D. (PRESIDENT)
(505) 293-5333
Entity
Organization

Contact information

Practice address
8100 CONSTITUTION PL NE, SUITE 310, ALBUQUERQUE, NM 87110-7643
(505) 293-5333
(505) 293-5334
Mailing address
8100 CONSTITUTION PL NE, SUITE 310, ALBUQUERQUE, NM 87110-7643
(505) 293-5333
(505) 293-5334

Taxonomy

Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
67-57
NM
207ND0101X
MOHS-Micrographic Surgery Physician
67-57
NM
207ND0900X
Dermatopathology Physician
67-57
NM
207NP0225X
Pediatric Dermatology Physician
67-57
NM
207NS0135X
Procedural Dermatology Physician
Primary
67-57
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
20107
NM
Enumeration date
10/08/2006
Last updated
08/22/2007
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