MEDICARE: WENDY SUZUKO NAKASHIMA CNM

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	F000255-1	NY

General Provider Information

NPI Number	:	1255583100
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WENDY SUZUKO NAKASHIMA CNM

Provider Business Mailing Address
First Line	:	305 RIVERSIDE DRIVE
Second Line	:	#5B
City	:	NEW YORK CITY
State	:	NY
Zip	:	10025
Country	:	US
Telephone Number	:	212-222-9218
Fax Number	:	212-222-9218

Provider Business Practice Location Address
First Line	:	305 RIVERSIDE DRIVE
Second Line	:
City	:	NEW YORK CITY
State	:	NY
Zip	:	10025
Country	:	US
Telephone Number	:	212-222-9218
Fax Number	:	212-222-9218

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/22/2008
Last Update Date	:	10/22/2008

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