Wackocki, William
Wackocki, William is an individual health care provider with primary practice located at 2720 San Pedro Dr Ne , Albuquerque NM 87110-3333. He recently has only one registered license in Other Service Providers / Community Health Worker, which is considered as his primary health care specialty. Wackocki, William can be contacted via phone (505) 265-7936.Contact Information
Primary practice address
2720 San Pedro Dr Ne
Albuquerque NM 87110-3333
Phone: (505) 265-7936
Fax: (505) 265-9685
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Community Health Worker | 172V00000X |
Profile Details
| NPI number | 1487977898 |
|---|---|
| LBN Legal business name | Wackocki, William |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 12th, 2010 |
| Last updated | Mar 12th, 2010 - about 15 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 | 1487977898 | NPPES |
| New Mexico | MEDICAID | D3124 |
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