Provider Demographics
NPI:1508552589
Name:PORTER, NATASHA (CNM)
Entity Type:Individual
Prefix:
First Name:NATASHA
Middle Name:
Last Name:PORTER
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 1:1006 E 35TH ST APT 3
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11210-3456
Mailing Address - Country:US
Mailing Address - Phone:917-803-1137
Mailing Address - Fax:
Practice Address - Street 1:1006 E 35TH ST APT 3
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11210-3456
Practice Address - Country:US
Practice Address - Phone:917-803-1137
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-13
Last Update Date:2023-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF002209176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife