Healthcare Provider Details

I. General information

NPI: 1427882158
Provider Name (Legal Business Name): ELIZABETH D'AMELIO CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/27/2024
Last Update Date: 11/14/2025
Certification Date: 11/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1124 GALLERY PARK LN
WILMINGTON NC
28412-1142
US

IV. Provider business mailing address

830 W 177TH ST APT 4F
NEW YORK NY
10033-6621
US

V. Phone/Fax

Practice location:
  • Phone: 910-343-1031
  • Fax: 910-251-8896
Mailing address:
  • Phone: 973-513-0224
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License NumberCNM09648
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: