1801885330 NPI number — KRISTINA TOCCE MD

Table of content: KRISTINA TOCCE MD (NPI 1801885330)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1801885330 NPI number — KRISTINA TOCCE MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
TOCCE
Provider First Name:
KRISTINA
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1801885330
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/25/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
719 SAN MATEO BLVD NE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ALBUQUERQUE
Provider Business Mailing Address State Name:
NM
Provider Business Mailing Address Postal Code:
87108-1434
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
505-485-0464
Provider Business Mailing Address Fax Number:
505-266-1017

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
12605 E 16TH AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
AURORA
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
80045-2545
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
720-848-0000
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/18/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207V00000X , with the licence number:  11675A , registered in the state of WY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207V00000X , with the licence number: MD2018-0784 , registered in the state of NM ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207V00000X , with the licence number: 44152 , registered in the state of CO ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 207V00000X , with the licence number: 18253 , registered in the state of NV ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 18253 . This is a "NEVADA LICENSE" identifier , issued by the state of ( NV ) . This identifiers is of the category "OTHER".
  • Identifier: 71037349 , issued by the state of ( CO ) . This identifiers is of the category "MEDICAID".
  • Identifier: DR.0044152 . This is a "COLORADO LICENSE" identifier , issued by the state of ( CO ) . This identifiers is of the category "OTHER".
  • Identifier: 75956373 , issued by the state of ( NM ) . This identifiers is of the category "MEDICAID".
  • Identifier: MD2018-0784 . This is a "NEW MEXICO LICENSE" identifier , issued by the state of ( NM ) . This identifiers is of the category "OTHER".




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