MEDICARE: MS. RUTH MANKOFF 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	367A00000X	Advanced Practice Midwife	F 000310	NY

General Provider Information

NPI Number	:	1407859952
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. RUTH MANKOFF CNM

Provider Business Mailing Address
First Line	:	4 VALLEY VIEW CT
Second Line	:
City	:	POMONA
State	:	NY
Zip	:	10970-2114
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1650 GRAND CONCOURSE
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10457-7606
Country	:	US
Telephone Number	:	718-239-8380
Fax Number	:

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

Provider Enumeration Date	:	05/28/2005
Last Update Date	:	07/08/2007

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