Provider Demographics
NPI:1902905813
Name:ALBERTSON, NAOMI LENORE (MD)
Entity Type:Individual
Prefix:DR
First Name:NAOMI
Middle Name:LENORE
Last Name:ALBERTSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:5590 KIETZKE LN
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89511-3019
Mailing Address - Country:US
Mailing Address - Phone:757-323-2080
Mailing Address - Fax:775-786-1887
Practice Address - Street 1:5590 KIETZKE LN
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89511-3019
Practice Address - Country:US
Practice Address - Phone:757-323-2080
Practice Address - Fax:775-325-2334
Is Sole Proprietor?:No
Enumeration Date:2006-09-21
Last Update Date:2022-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV14874207QS0010X, 207QS0010X, 207QS0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QS0010XAllopathic & Osteopathic PhysiciansFamily MedicineSports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
12551109OtherCAQH
NV1902905813Medicaid
CA00A745420Medicare PIN