Provider Demographics
NPI:1790473460
Name:EMPOWER MAMASITA SERVICES
Entity Type:Organization
Organization Name:EMPOWER MAMASITA SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ANGELINE
Authorized Official - Middle Name:
Authorized Official - Last Name:IRRIZARRI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:862-267-8685
Mailing Address - Street 1:364 EDMUND AVE
Mailing Address - Street 2:
Mailing Address - City:PATERSON
Mailing Address - State:NJ
Mailing Address - Zip Code:07502-1358
Mailing Address - Country:US
Mailing Address - Phone:862-228-4467
Mailing Address - Fax:
Practice Address - Street 1:364 EDMUND AVE
Practice Address - Street 2:
Practice Address - City:PATERSON
Practice Address - State:NJ
Practice Address - Zip Code:07502-1358
Practice Address - Country:US
Practice Address - Phone:862-228-4467
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-01
Last Update Date:2023-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374J00000XNursing Service Related ProvidersDoulaGroup - Multi-Specialty
No174H00000XOther Service ProvidersHealth EducatorGroup - Multi-Specialty