Provider Demographics
NPI:1497469043
Name:NASIRA WATERS LLC
Entity Type:Organization
Organization Name:NASIRA WATERS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EDUCATION SPECIALIST
Authorized Official - Prefix:MS
Authorized Official - First Name:NASIRA
Authorized Official - Middle Name:T
Authorized Official - Last Name:WATERS
Authorized Official - Suffix:
Authorized Official - Credentials:MASTERS OF SPED
Authorized Official - Phone:347-291-6008
Mailing Address - Street 1:171 SOUTH ORANGE AVE, APT 301
Mailing Address - Street 2:
Mailing Address - City:SOUTH ORANGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07079
Mailing Address - Country:US
Mailing Address - Phone:347-291-6008
Mailing Address - Fax:
Practice Address - Street 1:7616 13TH AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11228
Practice Address - Country:US
Practice Address - Phone:718-630-5100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-09
Last Update Date:2023-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency