Healthcare Provider Details

I. General information

NPI: 1477167971
Provider Name (Legal Business Name): ELIZABETH JOY CHOUDHARY CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ELIZABETH JOY COOK CNM

II. Dates (important events)

Enumeration Date: 09/02/2020
Last Update Date: 08/09/2021
Certification Date: 08/09/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2580 HAYMAKER RD STE 201
MONROEVILLE PA
15146-3500
US

IV. Provider business mailing address

2580 HAYMAKER RD STE 201
MONROEVILLE PA
15146-3500
US

V. Phone/Fax

Practice location:
  • Phone: 412-856-7500
  • Fax: 412-856-6079
Mailing address:
  • Phone: 412-856-7500
  • Fax: 412-856-6079

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License NumberMW010593
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code176B00000X
TaxonomyMidwife
License NumberMW010593
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: