Lake, Charissa
Lake, Charissa is an individual health care provider with primary practice located at 201 Cedar St Se Ste 4660 , Albuquerque NM 87106-4924. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatric Surgery, which is considered as her primary health care specialty. Lake, Charissa can be contacted via phone (505) 563-6530.Contact Information
Primary practice address
201 Cedar St Se Ste 4660
Albuquerque NM 87106-4924
Phone: (505) 563-6530
Fax: (505) 224-7479
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatric Surgery | 2086S0120X | MD2026-0775 | New Mexico |
Profile Details
| NPI number | 1124479225 |
|---|---|
| LBN Legal business name | Lake, Charissa |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 29th, 2016 |
| Last updated | Sep 28th, 2026 - about 12.853009259259 days 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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