Provider Demographics
NPI:1568455756
Name:LOVE, BRYNNE PATRICE (CNM)
Entity Type:Individual
Prefix:MRS
First Name:BRYNNE
Middle Name:PATRICE
Last Name:LOVE
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1037 MAIN ST
Mailing Address - Street 2:HUDSON RIVER HEALTHCARE, INC.
Mailing Address - City:PEEKSKILL
Mailing Address - State:NY
Mailing Address - Zip Code:10566-2913
Mailing Address - Country:US
Mailing Address - Phone:914-734-8800
Mailing Address - Fax:914-734-8786
Practice Address - Street 1:1037 MAIN ST
Practice Address - Street 2:HUDSON RIVER HEALTHCARE, INC.
Practice Address - City:PEEKSKILL
Practice Address - State:NY
Practice Address - Zip Code:10566-2913
Practice Address - Country:US
Practice Address - Phone:914-734-8790
Practice Address - Fax:914-734-8771
Is Sole Proprietor?:No
Enumeration Date:2005-08-24
Last Update Date:2015-10-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ25ME00041300207V00000X
NYF001424176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No176B00000XOther Service ProvidersMidwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0061921Medicaid
NY03321693Medicaid
NJ089365Medicare ID - Type Unspecified
NJ0061921Medicaid