Provider Demographics
NPI:1982045472
Name:MEET UR BABY 3D AT MADELINE'S PLACE
Entity Type:Organization
Organization Name:MEET UR BABY 3D AT MADELINE'S PLACE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:MAIRA
Authorized Official - Middle Name:
Authorized Official - Last Name:SANTIAGO
Authorized Official - Suffix:
Authorized Official - Credentials:RDMS
Authorized Official - Phone:570-369-8888
Mailing Address - Street 1:808 SEVEN BRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:EAST STROUDSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:18301-7942
Mailing Address - Country:US
Mailing Address - Phone:570-369-8888
Mailing Address - Fax:
Practice Address - Street 1:808 SEVEN BRIDGE RD
Practice Address - Street 2:
Practice Address - City:EAST STROUDSBURG
Practice Address - State:PA
Practice Address - Zip Code:18301-7942
Practice Address - Country:US
Practice Address - Phone:570-369-8888
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-11
Last Update Date:2013-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA26301261QB0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QB0400XAmbulatory Health Care FacilitiesClinic/CenterBirthing