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General NPI Number Information
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NPI Number | 1235784653
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Entity Type | Organization
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Legal Business Name | NORTHEAST MOMS AND BABIES, PLLC
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Dates
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Enumeration Date | 08/02/2019
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Last Update Date | 08/02/2019
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Provider Practice Location Address
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Address Line | 19 OLD MILL RD
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City | NORFOLK
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State | MA
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Zip | 02056-1435
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Country | US
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Telephone | 508-203-1553
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Fax |
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Provider Business Mailing Address
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Address Line | 19 OLD MILL RD
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City | NORFOLK
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State | MA
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Zip | 02056-1435
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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 | CO-FOUNDER
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Name | KIM BYDA
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Credential | NP, IBCLC
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Telephone | 617-875-8899
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LW0102X
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Taxonomy Name | Women's Health Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number |
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License Number State |
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