=====================================================
General NPI Number Information
=====================================================
NPI Number | 1427768878
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | WITH WOMAN WELLNESS OF MIDWIFERY, PLLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/28/2022
-----------------------------------------------------
Last Update Date | 07/20/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1991 SARANAC AVE STE 104
-----------------------------------------------------
City | LAKE PLACID
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 12946-1131
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 518-888-4109
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 32 CORLISS POINT WAY
-----------------------------------------------------
City | KEENE
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 12942-1929
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER/PROVIDER
-----------------------------------------------------
Name | SARA POSDZICH
-----------------------------------------------------
Credential | CNM
-----------------------------------------------------
Telephone | 518-524-8689
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 367A00000X
-----------------------------------------------------
Taxonomy Name | Advanced Practice Midwife
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------