Provider Demographics
NPI:1831605120
Name:LAS MULTI MEDIA PRODUCTIONS LLC
Entity type:Organization
Organization Name:LAS MULTI MEDIA PRODUCTIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:APRN
Authorized Official - Prefix:MS
Authorized Official - First Name:LEE
Authorized Official - Middle Name:A
Authorized Official - Last Name:SIUZDAK
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:203-206-6072
Mailing Address - Street 1:35 PORTER AVE
Mailing Address - Street 2:
Mailing Address - City:NAUGATUCK
Mailing Address - State:CT
Mailing Address - Zip Code:06770-1973
Mailing Address - Country:US
Mailing Address - Phone:203-206-6072
Mailing Address - Fax:
Practice Address - Street 1:35 PORTER AVE
Practice Address - Street 2:
Practice Address - City:NAUGATUCK
Practice Address - State:CT
Practice Address - Zip Code:06770-1973
Practice Address - Country:US
Practice Address - Phone:203-206-6072
Practice Address - Fax:203-206-6072
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-12-21
Last Update Date:2017-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT4587163WP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, AdultGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT008056413Medicaid