MEDICARE: BIRTH AND BEYOND INC,

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	176B00000X	Midwife	000240	CT

General Provider Information

NPI Number	:	1003087354
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BIRTH AND BEYOND INC,

Provider Business Mailing Address
First Line	:	411 DURHAM RD
Second Line	:
City	:	MADISON
State	:	CT
Zip	:	06443-2041
Country	:	US
Telephone Number	:	203-318-8884
Fax Number	:

Provider Business Practice Location Address
First Line	:	411 DURHAM RD
Second Line	:
City	:	MADISON
State	:	CT
Zip	:	06443-2041
Country	:	US
Telephone Number	:	203-318-8884
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	VICKI MARNIN
Credential	:	CNM
Telephone Number	:	203-318-8884

Provider Enumeration Date	:	03/14/2008
Last Update Date	:	03/14/2008

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