IndividualActive
Doreen Siracusano, PA-C/ MA
NPI 1679583710 · Medical Physician Assistant · Albuquerque, NM
Provider details
- NPI number
- 1679583710
- Entity type
- Individual
- Primary specialty
- Medical Physician AssistantPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- PA-C/ MA
- Sex
- Female
- Sole proprietor
- No
- License
- 85PA013 (NM)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Practice location
1501 San Pedro Dr Se
Albuquerque, NM 87108-5153
Phone: (505) 265-1711
Fax: (505) 256-2819
Approximate (ZIP-level) locationGet directions
Mailing address
1501 San Pedro Dr Se
Albuquerque, NM 87108-5153
Registry dates
- Enumerated
- 2006-08-09
- Last updated
- 2007-07-08
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.