Healthcare Provider Details

I. General information

NPI: 1073224952
Provider Name (Legal Business Name): MY BUMP MY BABY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/12/2022
Last Update Date: 06/04/2025
Certification Date: 06/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16 E 40TH ST FL 4
NEW YORK NY
10016-0113
US

IV. Provider business mailing address

20203 56TH AVE
OAKLAND GARDENS NY
11364-1640
US

V. Phone/Fax

Practice location:
  • Phone: 929-400-5913
  • Fax:
Mailing address:
  • Phone: 929-250-4178
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VM0101X
TaxonomyMaternal & Fetal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: CHARLOTTE D WILLIAMS
Title or Position: CEO
Credential:
Phone: 929-250-4178