1811290331 NPI number — MARIA ALEXANDRA BELLA NUTRITION LLC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1811290331 NPI number — MARIA ALEXANDRA BELLA NUTRITION LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MARIA ALEXANDRA BELLA NUTRITION LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1811290331
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/29/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
347 5TH AVE
Provider Second Line Business Mailing Address:
SUITE 606
Provider Business Mailing Address City Name:
NEW YORK
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
10016-5010
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
212-433-0738
Provider Business Mailing Address Fax Number:
646-807-4812

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
347 5TH AVE
Provider Second Line Business Practice Location Address:
SUITE 606
Provider Business Practice Location Address City Name:
NEW YORK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10016-5010
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
212-433-0738
Provider Business Practice Location Address Fax Number:
646-807-4812
Provider Enumeration Date:
12/06/2010

Additional Information

Authorized Official

Authorized Official Last Name:
BELLA
Authorized Official First Name:
MARIA
Authorized Official Middle Name:
ALEXANDRA
Authorized Official Title or Position:
FOUNDER AND CEO
Authorized Official Telephone Number:
212-433-0738

Provider Taxonomy Codes

  • Taxonomy code: 133V00000X , with the licence number:  1027549 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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