La Fata, Salvatore

La Fata, Salvatore is an individual health care provider with primary practice located at 2020 Sheffield Dr , Clovis NM 88101-4940. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. La Fata, Salvatore can be contacted via phone (505) 762-4507.

Contact Information

Primary practice address
2020 Sheffield Dr Clovis NM 88101-4940
Phone: (505) 762-4507
Fax: (505) 762-7220
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 75-62 New Mexico

Profile Details

NPI number 1417946195
LBN Legal business name La Fata, Salvatore
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 17th, 2005
Last updated Jul 8th, 2007 - about 18 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 1417946195 NPPES
New Mexico MEDICAID 15651
New Mexico Other 1570

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