National Provider Identifier Database

JOURNEY PEDIATRICS PC
Primary Care


Contact Information

JOURNEY PEDIATRICS PC
8308 CONSTITUTION PL NE
ALBUQUERQUE, NM87110
Phone: 505-883-9570
Fax: 505-883-4163
Website:
Specialty Taxonomy Code
* Primary Care 261QP2300X

* Indicates primary specialty

NPI Profile & details for JOURNEY PEDIATRICS PC

NPI Number 1205205630
Legal business name
LBN
JOURNEY PEDIATRICS PC
Authorized official ALWYN KOIL - (OWNER)
Entity Organization
Organization subpart No
Enumeration date 09/16/2015
Last updated 09/25/2025 - About 8 months ago
Sole proprietor1 Not specified
Identifiers
  • NM License #: 2003-0567
  • NM Medicaid: 85684392

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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