Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
AMANDA FRANCES DERYLO, M.D.
DeactivatedAMANDA FRANCES DERYLO, M.D. is a Diagnostic Radiology healthcare provider located in RIO RANCHO, New Mexico. NPI 1760758064 is deactivated in the NPPES registry. Verify at CMS.
Diagnostic Radiology · RIO RANCHO, NM
This NPI has been deactivated.
The record was deactivated on March 20, 2025.
Deactivated NPIs are no longer valid for billing or credentialing. The provider may have retired, changed practice status, or had their NPI administratively deactivated.
Verify current licensure status with the NPPES NPI Registry or the relevant state medical board before relying on this record.
Registration Details
- NPI Number
- 1760758064
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Mar 30, 2012 (12.972602739726 yrs)
- Last Updated
- Jun 16, 2025
- Deactivated
- Mar 20, 2025
- Licenses
-
66825 (WI)MD2017-0803 (NM)
Practice Information
- Address
-
3001 BROADMOOR BLVD NERIO RANCHO, NM, 871442100Browse NM providers · Browse ZIP 87144
- Phone
- 5059947000
- Primary Specialty
-
Diagnostic Radiology
2085R0202X
- Additional Specialty
- Diagnostic Radiology
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.