1275682080 NPI number — CHERYL A. RYERSON, CFA, PC

Table of content: (NPI 1275682080)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1275682080 NPI number — CHERYL A. RYERSON, CFA, PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CHERYL A. RYERSON, CFA, PC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

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:
1275682080
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 3699
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
EDGEWOOD
Provider Business Mailing Address State Name:
NM
Provider Business Mailing Address Postal Code:
87015-3699
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
505-832-8982
Provider Business Mailing Address Fax Number:
505-832-8983

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3700 OSUNA RD NE
Provider Second Line Business Practice Location Address:
SUITE 614
Provider Business Practice Location Address City Name:
ALBUQUERQUE
Provider Business Practice Location Address State Name:
NM
Provider Business Practice Location Address Postal Code:
87109-4492
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
505-341-0070
Provider Business Practice Location Address Fax Number:
505-341-0304
Provider Enumeration Date:
01/10/2007

Additional Information

Authorized Official

Authorized Official Last Name:
RYERSON
Authorized Official First Name:
CHERYL
Authorized Official Middle Name:
A
Authorized Official Title or Position:
ADMINISTRATOR
Authorized Official Telephone Number:
505-832-8982

Provider Taxonomy Codes

  • Taxonomy code: 246ZS0410X , with the licence number:  00F751 , registered in the state of NM ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 00F751 . This is a "CERTIFICATION" identifier . This identifiers is of the category "OTHER".
  • Identifier: $$$$$$$$$ . This is a "SSN" identifier . This identifiers is of the category "OTHER".




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