1407280118 NPI number — EXECUTIVE RECOVERY COACH, INC

Table of content: RAMIZ MUNEER KIRMANI MD (NPI 1972287860)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1407280118 NPI number — EXECUTIVE RECOVERY COACH, INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
EXECUTIVE RECOVERY COACH, 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:
Provider Other Organization Name Type Code:
6
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:
1407280118
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/29/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
239 WEST ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
READING
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
01867-2848
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
781-439-2603
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
239 WEST ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
READING
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
01867-2848
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
781-439-2603
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/29/2013

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
CARRICK
Authorized Official First Name:
WILLIAM
Authorized Official Middle Name:
PAUL
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
781-439-2603

Provider Taxonomy Codes

  • Taxonomy code: 253Z00000X , with the licence number:  22583743 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 251J00000X , with the licence number: 156015 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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