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General NPI Number Information
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NPI Number | 1245429190
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Entity Type | Organization
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Legal Business Name | SPARROW
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Dates
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Enumeration Date | 10/16/2007
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Last Update Date | 10/16/2007
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Provider Practice Location Address
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Address Line | 901 E MOUNT HOPE AVE
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City | LANSING
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State | MI
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Zip | 48910-3207
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Country | US
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Telephone | 517-485-1153
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Fax |
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Provider Business Mailing Address
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Address Line | 5400 MALL DR W APT 3107
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City | LANSING
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State | MI
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Zip | 48917-3260
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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 | COORDINATOR
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Name | CYNTHIA ZALDOKAS
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Credential |
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Telephone | 517-355-3503
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282NC2000X
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Taxonomy Name | Children's Hospital
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License Number | 4301087677
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License Number State | MI
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