Provider Demographics
NPI:1245962323
Name:INDIGO PLANET INC.
Entity type:Organization
Organization Name:INDIGO PLANET INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SI
Authorized Official - Prefix:
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:
Authorized Official - Last Name:DANILOVICH
Authorized Official - Suffix:
Authorized Official - Credentials:MSED
Authorized Official - Phone:718-290-7806
Mailing Address - Street 1:2540 BATCHELDER ST APT 7M
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235-1560
Mailing Address - Country:US
Mailing Address - Phone:718-290-7806
Mailing Address - Fax:
Practice Address - Street 1:2540 BATCHELDER ST APT 7M
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11235-1560
Practice Address - Country:US
Practice Address - Phone:718-290-7806
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-28
Last Update Date:2022-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty