SHANA NISENBAUM

ALBUQUERQUE, NM
NPI1669715793
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy208000000X Pediatrics
(Licence: NM  A-1948-16)
Additional Taxonomies390200000X Student in an Organized Health Care Education/Training Program
(Licence: NM  R09-2013)
Enumeration Date2013-03-27
Last Update Date2016-06-30
Business Address
-- SHANA NISENBAUM DO
1100 CENTRAL AVE SE
ALBUQUERQUE, NM 87106-4930
Phone number: 505-724-7044
Mailing Address
-- SHANA NISENBAUM DO
PO BOX 26666 PHS PROVIDER ENROLLMENT
ALBUQUERQUE, NM 87125-6666
Phone number: 505-923-6770
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