Provider Demographics
NPI:1811193535
Name:PARK SLOPE MIDWIVES LLC
Entity Type:Organization
Organization Name:PARK SLOPE MIDWIVES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ROSEANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:SEMINARA
Authorized Official - Suffix:
Authorized Official - Credentials:CNM
Authorized Official - Phone:718-499-3636
Mailing Address - Street 1:126 TERRACE PL
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11218-1104
Mailing Address - Country:US
Mailing Address - Phone:718-499-3636
Mailing Address - Fax:718-788-0596
Practice Address - Street 1:502A 9TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11215-4103
Practice Address - Country:US
Practice Address - Phone:718-499-3636
Practice Address - Fax:718-788-0596
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-21
Last Update Date:2013-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes364SW0102XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistWomen's HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01785464Medicaid