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General NPI Number Information
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NPI Number | 1992195135
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Entity Type | Organization
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Legal Business Name | QEF'S MAGIC LLC
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Dates
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Enumeration Date | 01/26/2015
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Last Update Date | 01/26/2015
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Provider Practice Location Address
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Address Line | 447 ATLANTIC AVE
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City | BROOKLYN
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State | NY
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Zip | 11217-1702
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Country | US
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Telephone | 347-680-2500
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Fax |
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Provider Business Mailing Address
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Address Line | 447 ATLANTIC AVE
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City | BROOKLYN
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State | NY
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Zip | 11217-1702
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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 | LPN, CD
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Name | QEF DANIELLE JOHNSON
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Credential | CD
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Telephone | 347-680-2500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 374J00000X
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Taxonomy Name | Doula
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License Number | 123456789
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License Number State | NY
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