Healthcare Provider Details

I. General information

NPI: 1609691559
Provider Name (Legal Business Name): VANESSA LAFORTUNE-REMEDOR CM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/16/2024
Last Update Date: 11/16/2024
Certification Date: 11/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1037 MAIN ST
PEEKSKILL NY
10566-2913
US

IV. Provider business mailing address

22 SLEEPY HOLLOW DR
WAYNE NJ
07470-5814
US

V. Phone/Fax

Practice location:
  • Phone: 844-400-1975
  • Fax:
Mailing address:
  • Phone: 914-621-8104
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License NumberF002332-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: