1740729466 NPI number — NEST COLLABORATIVE NURSING AND LACTATION SERVICES , PC

Table of content: (NPI 1740729466)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1740729466 NPI number — NEST COLLABORATIVE NURSING AND LACTATION SERVICES , PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NEST COLLABORATIVE NURSING AND LACTATION SERVICES , PC
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:
NEST COLLABORATIVE, INC
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:
1740729466
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/13/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2299 SUMMER ST STE 1184
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
STAMFORD
Provider Business Mailing Address State Name:
CT
Provider Business Mailing Address Postal Code:
06905-4502
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
888-598-1554
Provider Business Mailing Address Fax Number:
844-364-2618

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
822 GUILFORD AVE STE 1560
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BALTIMORE
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21202-3707
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
888-598-1554
Provider Business Practice Location Address Fax Number:
844-364-2618
Provider Enumeration Date:
02/14/2017

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
ROBERTS
Authorized Official First Name:
KAITLYN
Authorized Official Middle Name:
Authorized Official Title or Position:
CONTROLLER
Authorized Official Telephone Number:
75-363-6797

Provider Taxonomy Codes

  • Taxonomy code: 163WL0100X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363LP0200X , with the licence number: 214487 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363LP0200X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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