Provider Demographics
NPI:1518443787
Name:MOTHERBABY WELLNESS CENTER
Entity Type:Organization
Organization Name:MOTHERBABY WELLNESS CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER
Authorized Official - Prefix:
Authorized Official - First Name:ZINA
Authorized Official - Middle Name:L
Authorized Official - Last Name:BROCKMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DOULA, LMT
Authorized Official - Phone:347-327-4279
Mailing Address - Street 1:11755 122ND PL SIDE DOOR
Mailing Address - Street 2:
Mailing Address - City:SOUTH OZONE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11420-2723
Mailing Address - Country:US
Mailing Address - Phone:347-327-4279
Mailing Address - Fax:
Practice Address - Street 1:11755 122ND PL SIDE DOOR
Practice Address - Street 2:
Practice Address - City:SOUTH OZONE PARK
Practice Address - State:NY
Practice Address - Zip Code:11420-2723
Practice Address - Country:US
Practice Address - Phone:347-327-4279
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-11
Last Update Date:2023-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Multi-Specialty