Provider Demographics
NPI:1023368388
Name:NINEWAYS CONSULTANT, INC
Entity Type:Organization
Organization Name:NINEWAYS CONSULTANT, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JUAN
Authorized Official - Middle Name:
Authorized Official - Last Name:FLORENTINO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:347-342-7429
Mailing Address - Street 1:3405 PUTNAM PLACE
Mailing Address - Street 2:APT B6
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10467
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3405 PUTNAM PL
Practice Address - Street 2:APT B6
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10467-2500
Practice Address - Country:US
Practice Address - Phone:347-342-7429
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-14
Last Update Date:2012-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management