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Contact Information

NEW MOM'S OF GREEN BAY SC
704 S WEBSTER AVE STOP 110
GREEN BAY, WI54301-3528
 Phone: 920-431-0200
 Fax: 920-431-0300
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Maternal & Fetal Medicine

207VM0101X 16 Physician/Obstetrics & Gynecology
 

Clinic/Center

261Q00000X
Indicates primary specialty

NPI Profile & details for NEW MOM'S OF GREEN BAY SC

NPI # 1558534313
LBN Legal business name NEW MOM'S OF GREEN BAY SC
Authorized official ALLAHYAR JAZAYERI - (PRESIDENT/OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 04/11/2008
Last updated 12/04/2009 - About 17 years ago
Identifiers
WI License # 44616020
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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