Provider Demographics
NPI:1447509880
Name:EXECU-SEARCH
Entity type:Organization
Organization Name:EXECU-SEARCH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED NURSE
Authorized Official - Prefix:MS
Authorized Official - First Name:MARLENA
Authorized Official - Middle Name:
Authorized Official - Last Name:SALOMON
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:917-593-9820
Mailing Address - Street 1:2238 E 1ST ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11223-5144
Mailing Address - Country:US
Mailing Address - Phone:917-593-9820
Mailing Address - Fax:
Practice Address - Street 1:2238 E 1ST ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11223-5144
Practice Address - Country:US
Practice Address - Phone:917-593-9820
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-30
Last Update Date:2012-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY641401261QC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health