Healthcare Provider Details

I. General information

NPI: 1366431629
Provider Name (Legal Business Name): MARY BETH D'ALOIA CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/19/2005
Last Update Date: 06/02/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24 COMPUTER DR W
ALBANY NY
12205-1679
US

IV. Provider business mailing address

24 COMPUTER DR W
ALBANY NY
12205-1679
US

V. Phone/Fax

Practice location:
  • Phone: 518-689-7548
  • Fax: 518-489-9431
Mailing address:
  • Phone: 518-689-7548
  • Fax: 518-489-9431

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: