MEDICARE: MS. SUSAN GREENBERG YARMUSH 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	001166

General Provider Information

NPI Number	:	1396723094
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. SUSAN GREENBERG YARMUSH CNM

Provider Business Mailing Address
First Line	:	280 RIVERSIDE DR
Second Line	:	APT. GB
City	:	NEW YORK
State	:	NY
Zip	:	10025-9010
Country	:	US
Telephone Number	:	845-596-9110
Fax Number	:

Provider Business Practice Location Address
First Line	:	227 MADISON ST
Second Line	:	MEDICAL STAFF OFFICE, ROOM 1249
City	:	NEW YORK
State	:	NY
Zip	:	10002-7537
Country	:	US
Telephone Number	:	212-238-7680
Fax Number	:

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

Provider Enumeration Date	:	01/04/2006
Last Update Date	:	07/08/2007

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