Healthcare Provider Details

I. General information

NPI: 1689593303
Provider Name (Legal Business Name): MY GENTLE START LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/15/2026
Last Update Date: 07/15/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3755 HENRY HUDSON PKWY APT 12F
BRONX NY
10463-1539
US

IV. Provider business mailing address

3755 HENRY HUDSON PKWY APT 12F
BRONX NY
10463-1539
US

V. Phone/Fax

Practice location:
  • Phone: 917-699-3361
  • Fax:
Mailing address:
  • Phone: 917-699-3361
  • 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 C LAX
Title or Position: OWNER
Credential: DOULA
Phone: 516-316-5015