Andreatta, Mario J.
Andreatta, Mario J. is an individual health care provider with primary practice located at 4025 Jackie Rd Se , Rio Rancho NM 87124-6610. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Andreatta, Mario J. can be contacted via phone (505) 892-8411.Contact Information
Primary practice address
4025 Jackie Rd Se
Rio Rancho NM 87124-6610
Phone: (505) 892-8411
Fax: (505) 891-5497
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | OP2438 | New Mexico |
Profile Details
| NPI number | 1134127004 |
|---|---|
| LBN Legal business name | Andreatta, Mario J. |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 13th, 2005 |
| Last updated | Apr 23rd, 2008 - about 16 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1134127004 | NPPES |
| Arizona | Other | 006007 | AHCCCS |
| Arizona | Other | NM0438 | AHCCCS |
| Arizona | Other | NMOP2438 | AHCCCS |
| Arizona | MEDICAID | 152W0000X | AHCCCS |
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