Provider Demographics
NPI:1093498420
Name:LILAC HEALTH MIDWIFERY GROUP OF SAVANNAH LLC
Entity Type:Organization
Organization Name:LILAC HEALTH MIDWIFERY GROUP OF SAVANNAH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ORGANIZER
Authorized Official - Prefix:MR
Authorized Official - First Name:NAFTULI
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHLUSSEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-913-3383
Mailing Address - Street 1:1550 39TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11218-4414
Mailing Address - Country:US
Mailing Address - Phone:718-913-3383
Mailing Address - Fax:
Practice Address - Street 1:1692 CHATHAM PKWY
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31405-1350
Practice Address - Country:US
Practice Address - Phone:912-629-6262
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-11
Last Update Date:2023-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice MidwifeGroup - Single Specialty