Maria Nicola Disebastiano, CERTIFIED COACH

Key facts

NPI

1992409536

Entity type

Individual (NPI type 1)

Primary specialty

Health & Wellness Coach 171400000X

Practice address

1401 Golden Rod CT Unit C
Belcamp, MD 21017-1661

Phone

(410) 598-4604

NPI assigned

Mar 28, 2023

Sex

Female

Sole proprietor

Yes

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Mar 28, 2023.

{
    "created_epoch": "1679961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679961600000",
    "number": "1992409536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 GOLDEN ROD CT UNIT C",
            "city": "BELCAMP",
            "state": "MD",
            "postal_code": "210171661",
            "telephone_number": "410-598-4604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 GOLDEN ROD CT UNIT C",
            "city": "BELCAMP",
            "state": "MD",
            "postal_code": "210171661",
            "telephone_number": "410-598-4604"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DISEBASTIANO",
        "first_name": "MARIA",
        "middle_name": "NICOLA",
        "credential": "CERTIFIED COACH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-03-28",
        "last_updated": "2023-03-28",
        "certification_date": "2023-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171400000X",
            "taxonomy_group": "",
            "desc": "Health & Wellness Coach",
            "state": "ID",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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All providers in Belcamp, MD · Health & Wellness Coach in Maryland