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
Phone: (505) 843-6168
Fax: (505) 792-1978
Website:
Health care specialties
| Specialty | Code | License # | 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1508907452 | NPPES |
| New Mexico | MEDICAID | 86080261 |
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