Healthcare Provider Details

I. General information

NPI: 1659378206
Provider Name (Legal Business Name): LINDA C GAGLIOTI CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/28/2005
Last Update Date: 12/21/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2183 OCEAN AVE
BROOKLYN NY
11229-2303
US

IV. Provider business mailing address

2183 OCEAN AVE
BROOKLYN NY
11229-2303
US

V. Phone/Fax

Practice location:
  • Phone: 718-336-4119
  • Fax: 718-336-4113
Mailing address:
  • Phone: 718-336-4119
  • Fax: 718-336-4113

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code176B00000X
TaxonomyMidwife
License NumberF000297-1
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License NumberF000297
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: