Healthcare Provider Details

I. General information

NPI: 1003723719
Provider Name (Legal Business Name): MY GENTLE START CT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/26/2026
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 CANAL ST # 29
STAMFORD CT
06902-5921
US

IV. Provider business mailing address

700 CANAL ST # 29
STAMFORD CT
06902-5921
US

V. Phone/Fax

Practice location:
  • Phone: 516-316-5015
  • Fax:
Mailing address:
  • Phone: 516-316-5015
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number State

VIII. Authorized Official

Name: RIVKA LAX
Title or Position: FOUNDER
Credential: DOULA
Phone: 516-316-5015