SHANTI BALKISSOON-CASTILLO DPM LLC (NPI# 1104483544) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104483544 |
| Entity Type | Organization |
| Organization Name | SHANTI BALKISSOON-CASTILLO DPM LLC |
| Practice Address |
7700 Menaul Blvd Ne Ste D Albuquerque NM 87110-4639 |
| Practice Telephone | 5052994487 |
| Practice Fax Number | 5052994498 |
| Mailing Telephone | 5052994487 |
| Mailing Fax Number | 5052994498 |
| Enumeration Date | 2019-05-21 |
| Last Update Date | 2019-05-29 |
| Authorized Official Name | SHANTI BALKISSOON-CASTILLO (OWNER) |
| Authorized Official Telephone | 5052994487 |
| Authorized Official Credential | DPM |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP1100X |
Clinic/Center Specialization: Podiatric |
Ambulatory Health Care Facilities |
| Street Address |
7700 MENAUL BLVD NE STE D |
| City | ALBUQUERQUE |
| State | NM |
| Zip Code | 87110-4639 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063418556 | Shanti Balkissoon-castillo | Podiatrist | 7700 Menaul Blvd Ne, Ste D, Albuquerque, NM 87110-4639 | 2005-06-21 |
| 1538430178 | Gay L Gustafson Dpm PC | Podiatrist | 7700 Menaul Blvd Ne, Ste D, Albuquerque, NM 87110-4616 | 2012-01-12 |
| 1134390073 | Gary D Prant | Durable Medical Equipment & Medical Supplies | 7700 Menaul Blvd Ne, Ste D, Albuquerque, NM 87110 | 2008-03-19 |
| 1003980178 | Gay L Gustafson | Podiatrist | 7700 Menaul Blvd Ne, Ste D, Albuquerque, NM 87110-4616 | 2006-11-20 |
| 1841219904 | Raymond Stephen Delvalle | Dentist | 7700 Menaul Blvd Ne, Albuquerque, NM 87110-4616 | 2006-07-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215550199 | Sabrina Jennifer Lujan | Counselor | 8401 Constitution Ave Nw, Albuquerque, NM 87110 | 2020-05-26 |
| 1649829318 | Robert D. Oliver | Technician | 2705 Texas Street Ne, Albuquerque, NM 87110 | 2019-09-05 |
| 1033770904 | Life Re-created LLC | Counselor | 3939 San Pedro Dr. Ne, Bld C, Ste 8, Albuquerque, NM 87110 | 2019-06-21 |
| 1497319693 | Clear Choice Vision Care, LLC | Optometrist | 6600 Menaul Blve Ne, Suite M5a, Albuquerque, NM 87110 | 2019-04-24 |
| 1790257558 | Diana M Nicolas | Dietitian, Registered | 8300 Constitution Ave Ne Bld D, Albuquerque, NM 87110 | 2018-12-18 |
| 1689168403 | Robin N Hermes, Md, PC | Anesthesiology | 2440 Lousiana Blvd. Ne, Ste 580, Albuquerque, NM 87110 | 2018-06-15 |
| 1710481726 | Desert Mountain Eyecare LLC | Optometrist | 5504 Menaul Blvd Ne Ste Aandb, Albuquerque, NM 87110 | 2018-03-23 |
| 1659873131 | Amanda Lacasse | Registered Nurse | 6400 Uptown Blvd Ne Suite 360 West, Albuquerque, NM 87110 | 2018-03-01 |
| 1518485655 | Danielle Liegh Wyne | Counselor | 6121 Indian School Rd, Suite 141, Albuquerque, NM 87110 | 2017-09-08 |
| 1265957237 | Myrrhine Faller | Speech-Language Pathologist | 6020 Constitution Ave. Ne, Suite 4, Albuquerque, NM 87110 | 2017-08-10 |
| Find all providers in zip 87110 | ||||
| Taxonomy Code | 261QP1100X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Podiatric |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154595825 | Synergy Wellness Center LLC | Clinic/Center | 4801 Lang Ave Ne, Suite 110, Albuquerque, NM 87109-4474 | 2008-04-14 |
| 1205973401 | Albuquerque Foot & Ankle, Inc. | Clinic/Center | 6821 Montgomery Blvd Ne, Suite D, Albuquerque, NM 87109 | 2007-01-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972127512 | Stephanie Gonzalez Dpm Pa | Clinic/Center | 4151 Camino Coyote Ste B, Las Cruces, NM 88011-7096 | 2020-05-29 |
| 1144841958 | Muojicare Medical Center LLC | Clinic/Center | 4500 N Sonoma Ranch Blvd, Las Cruces, NM 88011-7334 | 2020-05-04 |
| City | ALBUQUERQUE |
| Zip Code | 87110 |
Please comment or provide details below to improve the information on SHANTI BALKISSOON-CASTILLO DPM LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.