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General NPI Number Information
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NPI Number | 1134362601
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Entity Type | Organization
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Legal Business Name | AWFULLY BIG ADVENTURE INC
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Dates
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Enumeration Date | 04/14/2009
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Last Update Date | 04/14/2009
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Provider Practice Location Address
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Address Line | 118 E 28TH ST SUITE 1004
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City | NEW YORK
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State | NY
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Zip | 10016-8413
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Country | US
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Telephone | 917-805-0110
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Fax |
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Provider Business Mailing Address
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Address Line | 118 E 28TH ST SUITE 1004
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City | NEW YORK
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State | NY
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Zip | 10016-8413
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Country | US
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Telephone | 917-805-0110
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | MS. Z. MIER
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Credential |
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Telephone | 917-805-0110
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 172A00000X
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Taxonomy Name | Driver
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License Number | 726604723
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License Number State | NY
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