MEDICARE: DEFINITELY MIDWIFERY

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	367A00000X	Advanced Practice Midwife

General Provider Information

NPI Number	:	1386131365
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DEFINITELY MIDWIFERY

Provider Business Mailing Address
First Line	:	257 GRAND STREET, PO BOX 1114
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11211
Country	:	US
Telephone Number	:	516-690-7608
Fax Number	:

Provider Business Practice Location Address
First Line	:	257 GRAND ST # 1114
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11211-4302
Country	:	US
Telephone Number	:	516-572-0123
Fax Number	:

Authorized Official
Title or Position	:	MIDWIFE, CO-FOUNDER
Name	:	RENEE KATHLEEN FIORENTINO
Credential	:	LM
Telephone Number	:	516-690-7608

Provider Enumeration Date	:	04/16/2018
Last Update Date	:	05/10/2018

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