Tretyakova, Nadezda A
Tretyakova, Nadezda A is an individual health care provider with primary practice located at 80 B Veterans Blvd I-40, Exit 102, Acoma NM 87034. She recently has only one registered license in Allopathic & Osteopathic Physicians / General Practice, which is considered as her primary health care specialty. Tretyakova, Nadezda A can be contacted via phone (505) 552-5300.Contact Information
Primary practice address
80 B Veterans Blvd I-40, Exit 102
Acoma NM 87034
Phone: (505) 552-5300
Fax: (505) 552-5828
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / General Practice | 208D00000X | MD2013-0883 | New Mexico |
Profile Details
| NPI number | 1477832590 |
|---|---|
| LBN Legal business name | Tretyakova, Nadezda A |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 7th, 2011 |
| Last updated | Jul 9th, 2015 - about 11 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 | 1477832590 | NPPES |
| New Mexico | MEDICAID | H3451 |
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