Provider Demographics
NPI:1619199361
Name:MIDWIFERY CARE OF MONSEY, PC
Entity Type:Organization
Organization Name:MIDWIFERY CARE OF MONSEY, PC
Other - Org Name:DEBRA LENT BLOCH
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DEBRA
Authorized Official - Middle Name:LENT
Authorized Official - Last Name:BLOCH
Authorized Official - Suffix:
Authorized Official - Credentials:CNM
Authorized Official - Phone:845-356-3545
Mailing Address - Street 1:16 PARK AVE
Mailing Address - Street 2:
Mailing Address - City:AIRMONT
Mailing Address - State:NY
Mailing Address - Zip Code:10952-4507
Mailing Address - Country:US
Mailing Address - Phone:845-356-3545
Mailing Address - Fax:845-356-3445
Practice Address - Street 1:16 PARK AVE
Practice Address - Street 2:
Practice Address - City:AIRMONT
Practice Address - State:NY
Practice Address - Zip Code:10952-4507
Practice Address - Country:US
Practice Address - Phone:845-356-3545
Practice Address - Fax:845-356-3445
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-03
Last Update Date:2011-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF000869-1367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice MidwifeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02161237Medicaid