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Contact Information

ELIZABETH J RIEDEL, PA-C
1111 EL LLANO RD
ESPAÑOLA, NM87532-6727
 Phone: 505-929-1629
 Fax: 505-753-5815
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Medical

363AM0700X 97 Physician Assistant
Indicates primary specialty

NPI Profile & details for ELIZABETH J RIEDEL · (Female)

NPI # 1891788253
Status Active
Credentials PA-C (Physician Assistant-Certified)
Entity Individual
Enumeration date 08/31/2005
Last updated 07/01/2013 - About 13 years ago
Sole proprietor 1 No
Identifiers
  • NM License # 77-PA007
  • NM Medicaid 92726
  • NM Other NM400315 MEDICARE PTAN
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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