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General NPI Number Information
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NPI Number | 1225747546
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Entity Type | Individual
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Provider Name | LAURA ANGLEA GOOD CNM
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Gender | Female
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Dates
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Enumeration Date | 11/15/2022
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Last Update Date | 11/15/2022
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Provider Practice Location Address
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Address Line | 522 3RD ST
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City | BROOKLYN
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State | NY
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Zip | 11215-3003
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Country | US
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Telephone | 718-768-8500
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Fax |
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Provider Business Mailing Address
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Address Line | 5924 68TH RD
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City | RIDGEWOOD
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State | NY
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Zip | 11385-4446
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Country | US
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Telephone | 781-264-3011
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 176B00000X
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Taxonomy Name | Midwife
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License Number | 002189
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License Number State | NY
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