Healthcare Provider Details

I. General information

NPI: 1396588778
Provider Name (Legal Business Name): ELITE DOULAS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/14/2024
Last Update Date: 06/14/2024
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2714 FREDERICK DOUGLASS BLVD 5C
NEW YORK NY
10030
US

IV. Provider business mailing address

2714 FREDERICK DOUGLASS BLVD 5C
NEW YORK NY
10030
US

V. Phone/Fax

Practice location:
  • Phone: 718-500-4999
  • Fax:
Mailing address:
  • Phone: 718-500-4999
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code133N00000X
TaxonomyNutritionist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code133NN1002X
TaxonomyNutrition Education Nutritionist
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number State

VIII. Authorized Official

Name: MS. ISHA HANNAH LAMBKIN
Title or Position: OWNER
Credential:
Phone: 646-406-7285