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General NPI Number Information
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NPI Number | 1639401797
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Entity Type | Individual
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Provider Name | NISHA E ARIKUPURATHU CNM
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Gender | Female
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Dates
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Enumeration Date | 02/01/2010
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Last Update Date | 07/06/2024
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Provider Practice Location Address
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Address Line | 8906 135TH ST SUITE 6A
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City | JAMAICA
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State | NY
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Zip | 11418-2821
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Country | US
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Telephone | 718-206-6808
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Fax |
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Provider Business Mailing Address
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Address Line | 74 LAUREL DR
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City | NEW HYDE PARK
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State | NY
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Zip | 11040-2046
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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 |
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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 | 163WL0100X
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Taxonomy Name | Lactation Consultant (Registered Nurse)
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License Number | 572697
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 176B00000X
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Taxonomy Name | Midwife
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License Number | F001343
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License Number State | NY
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