Provider Demographics
NPI:1285490912
Name:BELLA BAMBINOS BOUTIQUE AND IMAGING, LLC
Entity type:Organization
Organization Name:BELLA BAMBINOS BOUTIQUE AND IMAGING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LINDSAY
Authorized Official - Middle Name:DANIELLE
Authorized Official - Last Name:NAIR
Authorized Official - Suffix:
Authorized Official - Credentials:ARDMS
Authorized Official - Phone:203-858-0463
Mailing Address - Street 1:902 OAKRIDGE CMNS
Mailing Address - Street 2:
Mailing Address - City:SOUTH SALEM
Mailing Address - State:NY
Mailing Address - Zip Code:10590-2442
Mailing Address - Country:US
Mailing Address - Phone:914-977-4312
Mailing Address - Fax:
Practice Address - Street 1:902 OAKRIDGE CMNS
Practice Address - Street 2:
Practice Address - City:SOUTH SALEM
Practice Address - State:NY
Practice Address - Zip Code:10590-2442
Practice Address - Country:US
Practice Address - Phone:914-977-4312
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BELLA BAMBINOS BOUTIQUE AND IMAGING, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-02-21
Last Update Date:2024-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2471S1302XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistSonographyGroup - Single Specialty