NPI Code Detail JSON Logo

1508606997 NPI number — SPRING VALLEY WELLNESS LLC

NPI Number: 1508606997
Health Care Provider/Practitioner: SPRING VALLEY WELLNESS LLC

Information about “1508606997” NPI (SPRING VALLEY WELLNESS LLC) exists in 1508606997 in HTML format HTML  |  1508606997 in plain Text format TXT  |  1508606997 in PDF (Portable Document Format) PDF  |  1508606997 in an XML format XML  formats.

NPI Number : 1508606997 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1508606997",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "SPRING VALLEY WELLNESS LLC",
    "LastName": null,
    "FirstName": null,
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": "6",
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "400 RELLA BLVD STE 165",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "SUFFERN",
    "MailingAddressStateName": "NY",
    "MailingAddressPostalCode": "10901-8114",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": null,
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "175 ROUTE 59 STE 170",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "SPRING VALLEY",
    "PracticeLocationAddressStateName": "NY",
    "PracticeLocationAddressPostalCode": "10977-5231",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "973-747-5217",
    "PracticeLocationAddressFaxNumber": "973-396-8832",
    "EnumerationDate": "05/31/2024",
    "LastUpdateDate": "05/31/2024",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "ESCOBAR",
    "AuthorizedOfficialFirstName": "LEO",
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": "CREDENTIALING OFFICER",
    "AuthorizedOfficialNamePrefix": "MR.",
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": "908-202-5690",
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "261QB0400X",
          "TaxonomyName": "Birthing Clinic/Center",
          "LicenseNumber": null,
          "LicenseNumberStateCode": "NULL",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "261QF0050X",
          "TaxonomyName": "Non-Surgical Family Planning Clinic/Center",
          "LicenseNumber": null,
          "LicenseNumberStateCode": "NULL",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "261QH0100X",
          "TaxonomyName": "Health Service Clinic/Center",
          "LicenseNumber": null,
          "LicenseNumberStateCode": "NULL",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "163WC1500X",
          "TaxonomyName": "Community Health Registered Nurse",
          "LicenseNumber": null,
          "LicenseNumberStateCode": "NULL",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "207V00000X",
          "TaxonomyName": "Obstetrics & Gynecology Physician",
          "LicenseNumber": null,
          "LicenseNumberStateCode": "NULL",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

Copyright © 2007-2026 Data Labs Health. All rights reserved.