Provider Demographics
NPI:1821336074
Name:VILLAGE BIRTH COOP
Entity Type:Organization
Organization Name:VILLAGE BIRTH COOP
Other - Org Name:VILLAGE BIRTH COOPERATIVE
Other - Org Type:Other Name
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:AZA
Authorized Official - Middle Name:
Authorized Official - Last Name:NEDHARI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:202-643-8317
Mailing Address - Street 1:7403 FLOWER AVE APT 1
Mailing Address - Street 2:
Mailing Address - City:TAKOMA PARK
Mailing Address - State:MD
Mailing Address - Zip Code:20912-6459
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7403 FLOWER AVE APT 1
Practice Address - Street 2:
Practice Address - City:TAKOMA PARK
Practice Address - State:MD
Practice Address - Zip Code:20912-6459
Practice Address - Country:US
Practice Address - Phone:202-643-8317
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-23
Last Update Date:2013-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374J00000XNursing Service Related ProvidersDoulaGroup - Multi-Specialty
No174H00000XOther Service ProvidersHealth EducatorGroup - Multi-Specialty
No174N00000XOther Service ProvidersLactation Consultant, Non-RNGroup - Multi-Specialty