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General NPI Number Information
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NPI Number | 1760906648
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Entity Type | Individual
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Provider Name | ANA KOLODKO CNM
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Gender | Female
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Dates
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Enumeration Date | 08/01/2017
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Last Update Date | 04/23/2024
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Provider Practice Location Address
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Address Line | 300 PROFESSIONAL VIEW DR
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City | FREEHOLD
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State | NJ
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Zip | 07728-0772
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Country | US
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Telephone | 732-432-1616
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Fax |
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Provider Business Mailing Address
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Address Line | 3165 NOSTRAND AVENUE 5 S
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City | BROOKLYN
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State | NY
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Zip | 11229
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Country | US
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Telephone | 646-353-2882
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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 | 176B00000X
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Taxonomy Name | Midwife
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License Number | 25ME00062301
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 367A00000X
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Taxonomy Name | Advanced Practice Midwife
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License Number | 25ME00062301
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License Number State | NJ
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