MEDICARE: LAURA ZEIDENSTEIN CNM, DRNP

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	176B00000X	Midwife	F000208	NY

General Provider Information

NPI Number	:	1730240763
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAURA ZEIDENSTEIN CNM, DRNP

Provider Business Mailing Address
First Line	:	16 FULLER PL
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11215-6007
Country	:	US
Telephone Number	:	212-305-5887
Fax Number	:	212-305-6937

Provider Business Practice Location Address
First Line	:	330 W 58TH ST
Second Line	:	SUITE 505
City	:	NEW YORK
State	:	NY
Zip	:	10019-1827
Country	:	US
Telephone Number	:	212-957-3006
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/13/2006
Last Update Date	:	07/08/2007

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