Pereira, Ismael
Pereira, Ismael is an individual health care provider with primary practice located at 4600 Montgomery Blvd Ne # B , Albuquerque NM 87109. He recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Medical, Allopathic & Osteopathic Physicians / Phlebology. Allopathic & Osteopathic Physicians / Phlebology is his primary health care specialty. Pereira, Ismael can be contacted via phone (505) 924-5840.Contact Information
Primary practice address
4600 Montgomery Blvd Ne # B
Albuquerque NM 87109
Phone: (505) 924-5840
Fax: (505) 924-5841
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Medical | 363AM0700X | PA20160096 | New Mexico |
| Allopathic & Osteopathic Physicians / Phlebology | 202K00000X | PA2016-0096 | New Mexico |
Profile Details
| NPI number | 1568913911 |
|---|---|
| LBN Legal business name | Pereira, Ismael |
| Credentials | Physician's Assistant Certified (PA-C) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 20th, 2016 |
| Last updated | Jul 28th, 2022 - about 3 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 | 1568913911 | NPPES |
| New Mexico | MEDICAID | PA20160096 |
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