Healthcare Provider Details

I. General information

NPI: 1841099876
Provider Name (Legal Business Name): BLOSSOM BIRTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/11/2025
Last Update Date: 03/11/2025
Certification Date: 03/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

117 CLINTON LN
SPRING VALLEY NY
10977-7836
US

IV. Provider business mailing address

33 SUNRISE DR UNIT 202
MONSEY NY
10952-6340
US

V. Phone/Fax

Practice location:
  • Phone: 845-587-2514
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QB0400X
TaxonomyBirthing Clinic/Center
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: TZIPORA WEISS
Title or Position: DOULA
Credential:
Phone: 845-521-6953