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General NPI Number Information
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NPI Number | 1538771647
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Entity Type | Organization
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Legal Business Name | MLM BUSINESS SOLUTION
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Dates
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Enumeration Date | 08/19/2020
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Last Update Date | 08/19/2020
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Provider Practice Location Address
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Address Line | 120 MAPLE DR
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City | ROOSEVELT
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State | NY
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Zip | 11575-2043
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Country | US
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Telephone |
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Fax |
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Provider Business Mailing Address
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Address Line | 120 MAPLE DR
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City | ROOSEVELT
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State | NY
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Zip | 11575-2043
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Country | US
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Telephone | 908-414-9300
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MAYOLINE MASCARY
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Credential | CEO & FOUNDER
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Telephone | 908-414-9300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 302R00000X
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Taxonomy Name | Health Maintenance Organization
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License Number |
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License Number State |
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