MEDICARE: EKD MIDWIFERY PC

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	001421	NY

General Provider Information

NPI Number	:	1962828145
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EKD MIDWIFERY PC

Provider Business Mailing Address
First Line	:	971 PUTNAM AVENUE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11221
Country	:	US
Telephone Number	:	347-216-5244
Fax Number	:	914-462-4409

Provider Business Practice Location Address
First Line	:	971 PUTNAM AVENUE #2
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11221
Country	:	US
Telephone Number	:	212-531-2229
Fax Number	:	914-462-4409

Authorized Official
Title or Position	:	MIDWIFE, PRACTICE OWNER
Name	:	MRS. ELAINE MICHELLE KELLER-DUEMIG
Credential	:	CNM
Telephone Number	:	347-559-1596

Provider Enumeration Date	:	03/11/2014
Last Update Date	:	03/12/2026

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