Grano, Rudy Fidencio
Grano, Rudy Fidencio is an sole proprietor health care provider with primary practice located at 213 Plaza St N/A, Las Vegas NM 87701-3432. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Grano, Rudy Fidencio can be contacted via phone (505) 617-6313.Contact Information
Primary practice address
213 Plaza St N/A
Las Vegas NM 87701-3432
Phone: (505) 617-6313
Fax: (505) 617-6313
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 103TC0700X | 0811 | New Mexico |
Profile Details
| NPI number | 1356452981 |
|---|---|
| LBN Legal business name | Grano, Rudy Fidencio |
| Credentials | PSYD |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Aug 31st, 2006 |
| Last updated | Apr 5th, 2013 - about 13 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 | 1356452981 | NPPES |
| New Mexico | MEDICAID | 17480221 |
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