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General NPI Number Information
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NPI Number | 1396687331
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Entity Type | Organization
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Legal Business Name | MERAKI COMMUNITY BIRTH CENTER
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Dates
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Enumeration Date | 04/08/2026
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Last Update Date | 04/08/2026
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Provider Practice Location Address
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Address Line | 301 W STATE ST
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City | ITHACA
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State | NY
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Zip | 14850-5431
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Country | US
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Telephone | 607-288-2336
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Fax | 607-304-5534
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Provider Business Mailing Address
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Address Line | 301 W STATE ST
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City | ITHACA
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State | NY
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Zip | 14850-5431
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Country | US
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Telephone | 607-288-2336
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Fax | 607-304-5534
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Authorized Official
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Title or Position | PRESIDENT
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Name | EMELINE MANDEVILLE
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Credential | MIDWIFE
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Telephone | 607-351-0764
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QB0400X
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Taxonomy Name | Birthing Clinic/Center
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License Number |
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License Number State |
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