Provider Demographics
NPI:1760293732
Name:PRO MATER LLC
Entity type:Organization
Organization Name:PRO MATER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOULA
Authorized Official - Prefix:
Authorized Official - First Name:KAUANE
Authorized Official - Middle Name:SILVIA
Authorized Official - Last Name:GONCALVES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:551-318-5554
Mailing Address - Street 1:34 WILLIAM ST APT 1
Mailing Address - Street 2:
Mailing Address - City:KEARNY
Mailing Address - State:NJ
Mailing Address - Zip Code:07032-1645
Mailing Address - Country:US
Mailing Address - Phone:551-318-5554
Mailing Address - Fax:
Practice Address - Street 1:34 WILLIAM ST APT 1
Practice Address - Street 2:
Practice Address - City:KEARNY
Practice Address - State:NJ
Practice Address - Zip Code:07032-1645
Practice Address - Country:US
Practice Address - Phone:551-318-5554
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-17
Last Update Date:2025-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374J00000XNursing Service Related ProvidersDoulaGroup - Multi-Specialty