Provider Demographics
NPI:1417581307
Name:BRADY-COLE, AMELIA BLYTHE (CD(DONA), CBC)
Entity Type:Individual
Prefix:
First Name:AMELIA
Middle Name:BLYTHE
Last Name:BRADY-COLE
Suffix:
Gender:F
Credentials:CD(DONA), CBC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1135 PARK PL APT 3
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11213-2601
Mailing Address - Country:US
Mailing Address - Phone:617-233-5790
Mailing Address - Fax:
Practice Address - Street 1:1135 PARK PL APT 3
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11213-2601
Practice Address - Country:US
Practice Address - Phone:617-233-5790
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-28
Last Update Date:2020-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula
No174N00000XOther Service ProvidersLactation Consultant, Non-RN