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General NPI Number Information
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NPI Number | 1124381660
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Entity Type | Organization
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Legal Business Name | OUR BABY, INC.
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Dates
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Enumeration Date | 06/20/2012
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Last Update Date | 06/20/2012
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Provider Practice Location Address
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Address Line | 7 HAMPTON CT
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City | LAKE SUCCESS
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State | NY
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Zip | 11020-1263
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Country | US
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Telephone | 917-648-0504
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Fax |
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Provider Business Mailing Address
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Address Line | 7 HAMPTON CT
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City | LAKE SUCCESS
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State | NY
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Zip | 11020-1263
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRES.
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Name | ROBERT DE SADOW
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Credential |
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Telephone | 917-648-0504
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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