Provider Demographics
NPI:1396396487
Name:COACH2CALM, INC.
Entity Type:Organization
Organization Name:COACH2CALM, INC.
Other - Org Name:NANCY FARBER
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:DESIGNATED OFFICAL
Authorized Official - Prefix:
Authorized Official - First Name:LUISA
Authorized Official - Middle Name:
Authorized Official - Last Name:DIMONDA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-761-9898
Mailing Address - Street 1:800 UNION ST APT 4B
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11215-1799
Mailing Address - Country:US
Mailing Address - Phone:516-312-0477
Mailing Address - Fax:
Practice Address - Street 1:800 UNION ST APT 4B
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11215-1799
Practice Address - Country:US
Practice Address - Phone:516-312-0477
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-20
Last Update Date:2021-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYF420264OtherLICENSE NUMBER