Provider Demographics
NPI:1174832133
Name:HERDAN, DEBORAH J (CNM)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:J
Last Name:HERDAN
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:220 CHURCH ST, 5TH FLOOR
Mailing Address - Street 2:PUBLIC HEALTH SOLUTIONS-MIC WOMEN'S HEALTH SERVICES
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10013
Mailing Address - Country:US
Mailing Address - Phone:646-619-6688
Mailing Address - Fax:646-619-6782
Practice Address - Street 1:220 CHURCH ST, 5TH FLOOR
Practice Address - Street 2:PUBLIC HEALTH SOLUTIONS-MIC WOMEN'S HEALTH SERVICES
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10013-2988
Practice Address - Country:US
Practice Address - Phone:646-619-6688
Practice Address - Fax:646-619-6782
Is Sole Proprietor?:No
Enumeration Date:2010-09-24
Last Update Date:2010-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000749367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife