Pucka, Beverly A
Pucka, Beverly A is an individual health care provider with primary practice located at 1001 Coal Ave Se , Albuquerque NM 87106-5205. She recently has only one registered license in Allopathic & Osteopathic Physicians / Gynecology, which is considered as her primary health care specialty. Pucka, Beverly A can be contacted via phone (505) 843-6168.Contact Information
Primary practice address
1001 Coal Ave Se
Albuquerque NM 87106-5205
Phone: (505) 843-6168
Fax: (505) 792-1978
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Gynecology | 207VG0400X | 86107 | New Mexico |
Profile Details
| NPI number | 1881701191 |
|---|---|
| LBN Legal business name | Pucka, Beverly A |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 23rd, 2006 |
| Last updated | May 23rd, 2018 - about 7 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 | 1881701191 | NPPES |
| New Mexico | MEDICAID | 37325 |
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