MEDICARE: MOTHER OCEAN MIDWIFERY

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
1	367A00000X	Advanced Practice Midwife

General Provider Information

NPI Number	:	1306611389
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MOTHER OCEAN MIDWIFERY

Provider Business Mailing Address
First Line	:	123 LINDEN BLVD APT 26D
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11226-9711
Country	:	US
Telephone Number	:	917-213-5313
Fax Number	:	917-277-8216

Provider Business Practice Location Address
First Line	:	1322 TROY AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11203-5730
Country	:	US
Telephone Number	:	917-213-5313
Fax Number	:	917-277-8216

Authorized Official
Title or Position	:	DIRECTOR OF MIDWIFERY SERVICES
Name	:	MALAIKA MILLER
Credential	:	CNM
Telephone Number	:	917-213-5313

Provider Enumeration Date	:	11/20/2023
Last Update Date	:	12/29/2023

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Directions to “MOTHER OCEAN MIDWIFERY ” Practice Location

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