1184852212 NPI number — STELLAR MIDWIFERY AND FERTILITY CONSULTATION

Table of content: DR. LAWRENCE SCOTT BLASZKOWSKY MD (NPI 1225028137)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1184852212 NPI number — STELLAR MIDWIFERY AND FERTILITY CONSULTATION

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
STELLAR MIDWIFERY AND FERTILITY CONSULTATION
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:
Provider Other Organization Name Type Code:
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:
1184852212
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/27/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
112 20TH AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SANTA CRUZ
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
95062-4961
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
503-936-5238
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
112 20TH AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SANTA CRUZ
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95062-4961
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
503-936-5238
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/27/2009

Additional Information

Authorized Official

Authorized Official Last Name:
BALDWIN
Authorized Official First Name:
EIRIS
Authorized Official Middle Name:
Authorized Official Title or Position:
CERTIFIED PROFESSIONAL MIDWIFE
Authorized Official Telephone Number:
503-936-5238

Provider Taxonomy Codes

  • Taxonomy code: 176B00000X , with the licence number:  LM247 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





Copyright © 2007-2025 www.npivalidator.com