Provider Demographics
NPI:1902827942
Name:COMMUNITY MIDWIFERY
Entity Type:Organization
Organization Name:COMMUNITY MIDWIFERY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:JOAN
Authorized Official - Middle Name:SYKES
Authorized Official - Last Name:BRYSON
Authorized Official - Suffix:
Authorized Official - Credentials:CNM LM
Authorized Official - Phone:718-788-0595
Mailing Address - Street 1:1622 8TH AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11215-5604
Mailing Address - Country:US
Mailing Address - Phone:718-788-0595
Mailing Address - Fax:718-788-5796
Practice Address - Street 1:1622 8TH AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11215-5604
Practice Address - Country:US
Practice Address - Phone:718-788-0595
Practice Address - Fax:718-788-5796
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF000365176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes176B00000XOther Service ProvidersMidwifeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
S54523Medicare UPIN
NYWIE211Medicare ID - Type Unspecified