Healthcare Provider Details

I. General information

NPI: 1518436146
Provider Name (Legal Business Name): MARIA CATALINA BERTANI CM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/13/2018
Last Update Date: 11/12/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9004 161ST ST
JAMAICA NY
11432-6141
US

IV. Provider business mailing address

750 RUGBY RD
BROOKLYN NY
11230-2410
US

V. Phone/Fax

Practice location:
  • Phone: 718-523-2123
  • Fax: 718-523-5833
Mailing address:
  • Phone: 646-510-5372
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License NumberF001903
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: