New Mom's of Green Bay SC

Primary specialty

Maternal & Fetal Medicine PhysicianTaxonomy code 207VM0101X

License

44616020 Issued in WI

Legal business name

NEW MOM'S OF GREEN BAY SC

Practice address

704 S Webster Ave Stop 110
Green Bay, WI 54301-3528

Phone

(920) 431-0200

Fax

(920) 431-0300

NPI assigned

Apr 11, 2008

Last updated

Dec 4, 2009By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Allahyar Jazayeri, M.D.

Title

President/Owner

Phone

(920) 338-6868

Specialties & licenses 2

Addresses

Tax ID family

New Moms of Green Bay SC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• New Moms of Green Bay SC

  • Obstetrics & Gynecology Physician
  • Green Bay, WI
  • NPI 1942349337
  NPD tax ID

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1207872000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1259884800000",
    "number": "1558534313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "704 S WEBSTER AVE STOP 110",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543013528",
            "telephone_number": "920-431-0200",
            "fax_number": "920-431-0300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "704 S WEBSTER AVE STOP 110",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543013528",
            "telephone_number": "920-431-0200",
            "fax_number": "920-431-0300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW MOM'S OF GREEN BAY SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-11",
        "last_updated": "2009-12-04",
        "status": "A",
        "authorized_official_last_name": "JAZAYERI",
        "authorized_official_first_name": "ALLAHYAR",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "920-338-6868",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "WI",
            "license": "44616020",
            "primary": false
        },
        {
            "code": "207VM0101X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Maternal & Fetal Medicine",
            "state": "WI",
            "license": "44616020",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• New Dermatology Group LTD
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• New Hair, LLC (Nell's Wigs and Boutique)
• New Hope Counseling Center of Wi, Inc.
• New Moms of Green Bay SC
• New Oral & Facial Surgery, SC
• New Pulmonary & Sleep Associates
• New Surgical Associates SC
• New Wellness Associates, Inc. (New Wellness Associates)

• Maternal & Fetal Medicine Physician in Green Bay, WI
• Providers in Green Bay, WI by specialty
• Maternal & Fetal Medicine Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.