NPI 1104133420 · live from the CMS NPI Registry
Sean Carlile, O.D.
Optometrist in Albuquerque, NM. National Provider Identifier 1104133420, active.
NPI record
| NPI | 1104133420 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Optometrist 152W00000X |
| Practice location | 1646 Alameda Blvd Nw, Albuquerque, NM 87114 |
| Practice phone | 505-792-3937 |
| Mailing address | 12400 Montgomery Blvd Ne Apt 32, Albuquerque, NM 87111 |
| Enumerated | September 8, 2010 |
| Last updated | September 8, 2010 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Optometrist primary | 152W00000X | 623 (NM) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.