MEDICARE: ERICKA ELIZABETH QUEZADA-YORK CNM, RN

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	001596	NY
2	367A00000X	Advanced Practice Midwife	001596	NY

General Provider Information

NPI Number	:	1821415506
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ERICKA ELIZABETH QUEZADA-YORK CNM, RN

Provider Business Mailing Address
First Line	:	430 5TH AVE FL 2
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11215-4013
Country	:	US
Telephone Number	:	917-742-0985
Fax Number	:

Provider Business Practice Location Address
First Line	:	14 DEKALB AVE FL 2
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11201-5311
Country	:	US
Telephone Number	:	718-875-4848
Fax Number	:	718-808-9548

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

Provider Enumeration Date	:	03/19/2014
Last Update Date	:	05/10/2022

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