=====================================================
General NPI Number Information
=====================================================
NPI Number | 1578883120
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | WOMEN MIDWIFERY HEALTH CARE SERVICE PC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/06/2010
-----------------------------------------------------
Last Update Date | 09/28/2016
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 48 MARKET ST STE B
-----------------------------------------------------
City | NEW YORK
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10002-8400
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 212-766-9751
-----------------------------------------------------
Fax | 212-766-1158
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 48 MARKET ST STE B
-----------------------------------------------------
City | NEW YORK
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10002-8400
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 212-766-9751
-----------------------------------------------------
Fax | 212-766-1158
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRES
-----------------------------------------------------
Name | ENG MEE MOONG MARILYN PAN
-----------------------------------------------------
Credential | CNM
-----------------------------------------------------
Telephone | 212-766-9751
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 367A00000X
-----------------------------------------------------
Taxonomy Name | Advanced Practice Midwife
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------