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General NPI Number Information
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NPI Number | 1013757996
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Entity Type | Organization
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Legal Business Name | BEACON COMMUNITY MIDWIFERY
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Dates
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Enumeration Date | 05/29/2024
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Last Update Date | 05/29/2024
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Provider Practice Location Address
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Address Line | 25 RALPH ST
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City | BEACON
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State | NY
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Zip | 12508-1842
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Country | US
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Telephone | 845-288-4771
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Fax |
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Provider Business Mailing Address
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Address Line | 25 RALPH ST
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City | BEACON
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State | NY
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Zip | 12508-1842
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | FOUNDER AND MIDWIFE
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Name | NICOLE PRIMOFF
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Credential | CNM
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Telephone | 845-288-4771
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 367A00000X
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Taxonomy Name | Advanced Practice Midwife
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License Number |
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License Number State |
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