Healthcare Provider Details

I. General information

NPI: 1114048618
Provider Name (Legal Business Name): ELIZABETH ARNOLD-LEAHY CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/02/2007
Last Update Date: 04/19/2023
Certification Date: 04/19/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

502A 9TH STREET
BROOKLYN NY
11215
US

IV. Provider business mailing address

502A 9TH STREET
BROOKLYN NY
11215
US

V. Phone/Fax

Practice location:
  • Phone: 718-499-3636
  • Fax: 718-788-0596
Mailing address:
  • Phone: 718-499-3636
  • Fax: 718-788-0596

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License NumberF00022
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License NumberF00022
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: