1134364706 NPI number — BRANCHES OF HOPE, INC.

Table of content: MANAL ELKARRA M.D. (NPI 1881965143)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1134364706 NPI number — BRANCHES OF HOPE, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BRANCHES OF HOPE, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
THE HOPE CENTER FOR AUTISM AND RELATED DISORDERS, LLC
Provider Other Organization Name Type Code:
4
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1134364706
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/10/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
19 LUDLOW RD STE 202
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WESTPORT
Provider Business Mailing Address State Name:
CT
Provider Business Mailing Address Postal Code:
06880-3040
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
203-227-3383
Provider Business Mailing Address Fax Number:
203-227-7490

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
19 LUDLOW RD STE 202
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WESTPORT
Provider Business Practice Location Address State Name:
CT
Provider Business Practice Location Address Postal Code:
06880-3040
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
203-227-3383
Provider Business Practice Location Address Fax Number:
203-227-7490
Provider Enumeration Date:
12/10/2008

Additional Information

Authorized Official

Authorized Official Last Name:
DYMENT
Authorized Official First Name:
JANIE
Authorized Official Middle Name:
E
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
203-227-3383

Provider Taxonomy Codes

  • Taxonomy code: 251C00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 251S00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 252Y00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 253Z00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)





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