Healthcare Provider Details

I. General information

NPI: 1932231859
Provider Name (Legal Business Name): ALICE GILGOFF CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/09/2007
Last Update Date: 04/02/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6 HENRY ST HUDSON RIVER HEALTHCARE, INC
BEACON NY
12508-3058
US

IV. Provider business mailing address

1037 MAIN ST HUDSON RIVER HEALTHCARE, INC.
PEEKSKILL NY
10566-2913
US

V. Phone/Fax

Practice location:
  • Phone: 845-831-0400
  • Fax: 845-831-0793
Mailing address:
  • Phone: 914-734-8858
  • Fax: 914-734-8786

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License NumberF000426
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: