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NPI Code Detail

MEDICARE: LESLIE M LUDKA CNM

MEDICARE: LESLIE M LUDKA CNM
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1367A00000XAdvanced Practice Midwife149422MA

General Provider Information

NPI Number : 1275656514
Entity Type Code : Individual
Provider Name (Legal Business Name) : LESLIE M LUDKA CNM
Provider Business Mailing Address
First Line : 10 CAMELIA AVE
Second Line :
City : CAMBRIDGE
State : MA
Zip : 02139-1008
Country : US
Telephone Number : 617-665-2229
Fax Number :
Provider Business Practice Location Address
First Line : 10 CAMELIA AVE
Second Line :
City : CAMBRIDGE
State : MA
Zip : 02139-1008
Country : US
Telephone Number : 617-665-2229
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/10/2007
Last Update Date : 07/08/2007

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Directions to “ LESLIE M LUDKA CNM” Practice Location

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