Provider Demographics
NPI:1104652213
Name:NORTHEAST INFUSION THERAPY INC
Entity type:Organization
Organization Name:NORTHEAST INFUSION THERAPY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NATALIE
Authorized Official - Middle Name:
Authorized Official - Last Name:LOPASIC
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:518-207-5674
Mailing Address - Street 1:767 TROY SCHENECTADY RD
Mailing Address - Street 2:
Mailing Address - City:LATHAM
Mailing Address - State:NY
Mailing Address - Zip Code:12110-2446
Mailing Address - Country:US
Mailing Address - Phone:518-207-5674
Mailing Address - Fax:
Practice Address - Street 1:767 TROY SCHENECTADY RD
Practice Address - Street 2:
Practice Address - City:LATHAM
Practice Address - State:NY
Practice Address - Zip Code:12110-2446
Practice Address - Country:US
Practice Address - Phone:518-207-5674
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-13
Last Update Date:2024-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QI0500XAmbulatory Health Care FacilitiesClinic/CenterInfusion Therapy