Provider Demographics
NPI:1972852218
Name:THE EXECUSEARCH GROUP
Entity Type:Organization
Organization Name:THE EXECUSEARCH GROUP
Other - Org Name:HEALTHCARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:LPN
Authorized Official - Prefix:
Authorized Official - First Name:YANIRYS
Authorized Official - Middle Name:
Authorized Official - Last Name:PEGUERO-MEJIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:917-981-7938
Mailing Address - Street 1:675 THIRD AVENUE
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10017
Mailing Address - Country:US
Mailing Address - Phone:917-981-7938
Mailing Address - Fax:
Practice Address - Street 1:675 THIRD AVENUE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10017
Practice Address - Country:US
Practice Address - Phone:917-981-7938
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-31
Last Update Date:2012-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY309751-1251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care