Provider Demographics
NPI:1821420506
Name:MCNYC
Entity type:Organization
Organization Name:MCNYC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CNM
Authorized Official - Prefix:MS
Authorized Official - First Name:SHAR
Authorized Official - Middle Name:AILI
Authorized Official - Last Name:LA PORTE
Authorized Official - Suffix:
Authorized Official - Credentials:CNM
Authorized Official - Phone:917-903-2898
Mailing Address - Street 1:201 ALLEN ST #1002
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10002-1492
Mailing Address - Country:US
Mailing Address - Phone:917-903-2898
Mailing Address - Fax:347-428-0580
Practice Address - Street 1:71-20 71ST PL
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:NY
Practice Address - Zip Code:11385-7250
Practice Address - Country:US
Practice Address - Phone:917-903-2898
Practice Address - Fax:347-428-0580
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-05
Last Update Date:2024-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF001372176B00000X, 176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes176B00000XOther Service ProvidersMidwifeGroup - Single Specialty