| Martin Ancona Llc | |
|
224 Anthony Dr Anthony NM 88021-9366 | |
| (214) 662-1791 | |
| Not Available |
| Full Name | Martin Ancona Llc |
|---|---|
| Speciality | Psychologist |
| Location | 224 Anthony Dr, Anthony, New Mexico |
| Authorized Official Name and Position | Martin Ancona (PH.D) |
| Authorized Official Contact | 2146621791 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Martin Ancona Llc 224 Anthony Dr Anthony NM 88021-9366 Ph: () - | Martin Ancona Llc 224 Anthony Dr Anthony NM 88021-9366 Ph: (214) 662-1791 |
| NPI Number | 1437713062 |
|---|---|
| Provider Enumeration Date | 04/29/2019 |
| Last Update Date | 10/09/2019 |
| Medicare PECOS PAC ID | 5496087744 |
|---|---|
| Medicare Enrollment ID | O20191106000410 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437713062 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Secondary |
| Provider Name | Martin Nicholas Ancona |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1003065749 PECOS PAC ID: 4789813700 Enrollment ID: I20140214000421 |
La Clinica De Familia, Incorporated Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 855 Anthony Dr, Anthony, NM 88021 Phone: 575-882-5706 Fax: 575-882-2909 | |
La Frontera Center Inc. Dba La Frontera New Mexico Inc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 880 N. Main St, Suite 3a, Anthony, NM 88021 Phone: 575-788-2510 | |
New Mexico Psychological Medicine, Llc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 224 Anthony Dr, Anthony, NM 88021 Phone: 575-520-2230 | |
La Clinica De Familia, Incorporated Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 100 Shrode Rd, Anthony, NM 88021 Phone: 575-674-2852 Fax: 575-674-2853 | |
Southern New Mexico Human Development, Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 820 Hwy 478, Anthony, NM 88021 Phone: 505-882-5101 Fax: 505-882-6127 | |
La Clinica De Familia, Incorporated Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 826 Anthony Dr, Anthony, NM 88021 Phone: 575-201-5135 Fax: 575-449-4052 |