Provider Demographics
NPI:1538781117
Name:NELLE TECHNOLOGY SERVIVES, INC.
Entity type:Organization
Organization Name:NELLE TECHNOLOGY SERVIVES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ERIK
Authorized Official - Middle Name:
Authorized Official - Last Name:LEUM
Authorized Official - Suffix:
Authorized Official - Credentials:BSC, MSIT
Authorized Official - Phone:561-351-4606
Mailing Address - Street 1:6644 MARBLETREE LN
Mailing Address - Street 2:
Mailing Address - City:LAKE WORTH
Mailing Address - State:FL
Mailing Address - Zip Code:33467-7234
Mailing Address - Country:US
Mailing Address - Phone:516-351-4606
Mailing Address - Fax:
Practice Address - Street 1:6644 MARBLETREE LN
Practice Address - Street 2:
Practice Address - City:LAKE WORTH
Practice Address - State:FL
Practice Address - Zip Code:33467-7234
Practice Address - Country:US
Practice Address - Phone:561-351-4606
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-18
Last Update Date:2020-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156F00000XEye and Vision Services ProvidersTechnician/TechnologistGroup - Single Specialty