Provider Demographics
NPI:1073310546
Name:FUNDACION SOS MUJER EXTRAORDINARIA CORP
Entity type:Organization
Organization Name:FUNDACION SOS MUJER EXTRAORDINARIA CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:BIANNYI
Authorized Official - Middle Name:
Authorized Official - Last Name:KASMAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:860-604-0319
Mailing Address - Street 1:4 KATHERINE WAY
Mailing Address - Street 2:
Mailing Address - City:ELLINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06029-5842
Mailing Address - Country:US
Mailing Address - Phone:860-604-0319
Mailing Address - Fax:
Practice Address - Street 1:4 KATHERINE WAY
Practice Address - Street 2:
Practice Address - City:ELLINGTON
Practice Address - State:CT
Practice Address - Zip Code:06029-5842
Practice Address - Country:US
Practice Address - Phone:860-604-0319
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-03
Last Update Date:2025-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health