Provider Demographics
NPI:1184084394
Name:ELDH, MCKENNA (LM, CM)
Entity type:Individual
Prefix:
First Name:MCKENNA
Middle Name:
Last Name:ELDH
Suffix:
Gender:F
Credentials:LM, CM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:502 9TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11215-4103
Mailing Address - Country:US
Mailing Address - Phone:718-499-3636
Mailing Address - Fax:
Practice Address - Street 1:502 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:
Is Sole Proprietor?:No
Enumeration Date:2016-03-01
Last Update Date:2023-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF001709-1176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife