Healthcare Provider Details

I. General information

NPI: 1407921562
Provider Name (Legal Business Name): KATHLEEN RITA AITKEN CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/22/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

234 E 149TH ST RM 5-18
BRONX NY
10451-5504
US

IV. Provider business mailing address

49 ELYSIAN AVE
NYACK NY
10960-4331
US

V. Phone/Fax

Practice location:
  • Phone: 718-579-5830
  • Fax: 718-579-4699
Mailing address:
  • Phone: 845-353-0428
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License NumberF-000649
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: