Provider Demographics
NPI:1669608030
Name:SEPTEMBER HILL MIDWIFERY
Entity type:Organization
Organization Name:SEPTEMBER HILL MIDWIFERY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE PROPRIETER/NURSE-MIDWIFE
Authorized Official - Prefix:MS
Authorized Official - First Name:DEBORA
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:BISSONNETTE
Authorized Official - Suffix:
Authorized Official - Credentials:CNM
Authorized Official - Phone:607-546-7936
Mailing Address - Street 1:3812 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BURDETT
Mailing Address - State:NY
Mailing Address - Zip Code:14818-9698
Mailing Address - Country:US
Mailing Address - Phone:607-546-7936
Mailing Address - Fax:
Practice Address - Street 1:3812 MAIN ST
Practice Address - Street 2:
Practice Address - City:BURDETT
Practice Address - State:NY
Practice Address - Zip Code:14818-9698
Practice Address - Country:US
Practice Address - Phone:607-546-7936
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-29
Last Update Date:2009-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000956176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes176B00000XOther Service ProvidersMidwifeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02172374Medicaid
NYCC6530Medicare UPIN