Organization Name: | STARLIGHT MANAGEMENT SERVICES PLUS CORP |
NPI Number: | 1417262783 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | MARAT MENDALIN (OWNER/PRESIDENT) |
Mailing Address: | 6 Landmark Sq Stamford |
State: | CT US |
Postal Code: | 069012704 |
Phone Number: | 2033595705 |
Fax Number: | |
NPI Enumeration Date: | 08/11/2010 |
NPI Last Update Date: | 08/11/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |