Healthcare Provider Details

I. General information

NPI: 1578883120
Provider Name (Legal Business Name): WOMEN MIDWIFERY HEALTH CARE SERVICE PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/06/2010
Last Update Date: 09/28/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

48 MARKET ST STE B
NEW YORK NY
10002-8400
US

IV. Provider business mailing address

48 MARKET ST STE B
NEW YORK NY
10002-8400
US

V. Phone/Fax

Practice location:
  • Phone: 212-766-9751
  • Fax: 212-766-1158
Mailing address:
  • Phone: 212-766-9751
  • Fax: 212-766-1158

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number
License Number State

VIII. Authorized Official

Name: ENG MEE MOONG MARILYN PAN
Title or Position: PRES
Credential: CNM
Phone: 212-766-9751