Provider Demographics
NPI:1962828145
Name:EKD MIDWIFERY
Entity Type:Organization
Organization Name:EKD MIDWIFERY
Other - Org Name:CENTRAL PARK MIDWIFERY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MIDWIFE, PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:ELAINE
Authorized Official - Middle Name:
Authorized Official - Last Name:KELLER-DUEMIG
Authorized Official - Suffix:
Authorized Official - Credentials:CNM
Authorized Official - Phone:347-216-5244
Mailing Address - Street 1:2280 FREDERICK DOUGLASS BLVD
Mailing Address - Street 2:APT 8F
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10027-5329
Mailing Address - Country:US
Mailing Address - Phone:347-216-5244
Mailing Address - Fax:
Practice Address - Street 1:285 W END AVE
Practice Address - Street 2:SUITE Y2
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10023-2504
Practice Address - Country:US
Practice Address - Phone:212-531-2229
Practice Address - Fax:914-462-4409
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-11
Last Update Date:2014-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY001421367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice MidwifeGroup - Single Specialty