Healthcare Provider Details

I. General information

NPI: 1912244351
Provider Name (Legal Business Name): BIRTHING MEDICAL GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/04/2013
Last Update Date: 01/04/2013
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: 718-376-6655
  • Fax: 718-336-4113
Mailing address:
  • Phone: 718-376-6655
  • Fax: 718-336-4113

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License NumberF000297
License Number StateNY

VIII. Authorized Official

Name: DR. JAMES DUCEY
Title or Position: MANAGING PARTNER
Credential: M.D.
Phone: 718-376-6655