Provider Demographics
NPI:1710767116
Name:BB-PENDA
Entity Type:Organization
Organization Name:BB-PENDA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:EFIA
Authorized Official - Middle Name:N
Authorized Official - Last Name:DALILI
Authorized Official - Suffix:
Authorized Official - Credentials:CERTIFIED DOULA
Authorized Official - Phone:443-527-6559
Mailing Address - Street 1:4014 AMY LN
Mailing Address - Street 2:
Mailing Address - City:RANDALLSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21133-3612
Mailing Address - Country:US
Mailing Address - Phone:443-527-6559
Mailing Address - Fax:
Practice Address - Street 1:4014 AMY LN
Practice Address - Street 2:
Practice Address - City:RANDALLSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21133-3612
Practice Address - Country:US
Practice Address - Phone:443-527-6559
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-03
Last Update Date:2023-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374J00000XNursing Service Related ProvidersDoulaGroup - Single Specialty