Doctor Name: | MR. NICHOLAS DEMECIO MEDINA |
NPI Number: | 1831478445 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | A.T.C. |
License Number: | 493 |
Business Practice Address: | 7007 Jefferson St Ne Ste C Albuquerque, NM - 871094450 |
Business Phone Number: | 5058214325 |
Business Fax Number: | |
Mailing Address: | 7007 Jefferson St Ne Ste C, ALBUQUERQUE |
State: | NM |
Postal Code: | 871094450 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 08/12/2011 |
NPI Last Update Date: | 08/12/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 171W00000X |
License Number: | 493 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NM |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Contractor |
Taxonomy Specialization: | |
Taxonomy Definition: | A person who contracts to supply certain materials or do certain work for a stipulated sum; esp., one whose business is contracting work in any of the building trades. For purposes of the taxonomy, a person who contracts to complete home repairs or modifications to accommodate a health condition (e.g. wheelchair ramp, kitchen counter lowering). |