Organization
JENIFER LICHTENFELS, MD, LLC
Active
Other names
Pediatrics After Hours
Organization subpart
No
Provider details
NPI number
Authorized official
KATRINA MARIE FERRALES (CREDENTIALING)
(505) 647-8366
Entity
Organization
Contact information
Practice address
2801 MISSOURI AVE, LAS CRUCES, NM 88011-5075
(505) 521-0630
(505) 521-0628
Mailing address
PO BOX 1560, LAS CRUCES, NM 88004-1560
(505) 647-8366
(505) 647-8381
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
88211
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00017053
—
NM
Enumeration date
05/21/2007
Last updated
10/29/2007
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