Chongsiriwatana, Kristina Marie

Chongsiriwatana, Kristina Marie is an individual health care provider with primary practice located at 4640 Jefferson Ln Ne , Albuquerque NM 87109-2116. She recently has only one registered license in Allopathic & Osteopathic Physicians / Obstetrics & Gynecology, which is considered as her primary health care specialty. Chongsiriwatana, Kristina Marie can be contacted via phone (505) 843-6168.

Contact Information

Primary practice address
4640 Jefferson Ln Ne Albuquerque NM 87109-2116
Fax: (505) 792-1978
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Obstetrics & Gynecology 207V00000X 2004-0276 New Mexico

Profile Details

NPI number 1508907452
LBN Legal business name Chongsiriwatana, Kristina Marie
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 12th, 2007
Last updated Jul 21st, 2020 - about 5 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1508907452 NPPES
New Mexico MEDICAID 86080261

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