Provider Demographics
NPI:1538805148
Name:YOUR NEIGHBORHOOD NURSE AND LAB
Entity type:Organization
Organization Name:YOUR NEIGHBORHOOD NURSE AND LAB
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ERIN
Authorized Official - Middle Name:M
Authorized Official - Last Name:BERRY
Authorized Official - Suffix:
Authorized Official - Credentials:RN,BDN
Authorized Official - Phone:202-409-4152
Mailing Address - Street 1:10 NEVILLE CT
Mailing Address - Street 2:
Mailing Address - City:SEWELL
Mailing Address - State:NJ
Mailing Address - Zip Code:08080-2736
Mailing Address - Country:US
Mailing Address - Phone:800-770-3134
Mailing Address - Fax:
Practice Address - Street 1:10 NEVILLE CT
Practice Address - Street 2:
Practice Address - City:SEWELL
Practice Address - State:NJ
Practice Address - Zip Code:08080-2736
Practice Address - Country:US
Practice Address - Phone:800-770-3134
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-06
Last Update Date:2022-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory