=====================================================
General NPI Number Information
=====================================================
NPI Number | 1649067943
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | DANA ROSE NEEMAN CNM
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/22/2025
-----------------------------------------------------
Last Update Date | 08/25/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 17 SYDNEY AVE
-----------------------------------------------------
City | FARMINGVILLE
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11738-1466
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 631-897-8337
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 17 SYDNEY AVE
-----------------------------------------------------
City | FARMINGVILLE
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11738-1466
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 631-897-8337
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 367A00000X
-----------------------------------------------------
Taxonomy Name | Advanced Practice Midwife
-----------------------------------------------------
License Number | F002409
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 163W00000X
-----------------------------------------------------
Taxonomy Name | Registered Nurse
-----------------------------------------------------
License Number | 774311
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------