Provider Demographics
NPI:1720027493
Name:LICHTMAN, RONNIE SUE (CNM, PHD, FACNM)
Entity Type:Individual
Prefix:DR
First Name:RONNIE
Middle Name:SUE
Last Name:LICHTMAN
Suffix:
Gender:F
Credentials:CNM, PHD, FACNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:310 NUBER AVE
Mailing Address - Street 2:
Mailing Address - City:MOUNT VERNON
Mailing Address - State:NY
Mailing Address - Zip Code:10553-1903
Mailing Address - Country:US
Mailing Address - Phone:914-668-8720
Mailing Address - Fax:914-665-3945
Practice Address - Street 1:450 CLARKSON AVE
Practice Address - Street 2:BOX 1227
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11203-2012
Practice Address - Country:US
Practice Address - Phone:917-496-6080
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-06
Last Update Date:2012-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF000141176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife