Provider Demographics
NPI:1932334315
Name:COMPLETE WOMAN MIDWIFERY & COMPLETE MEDICAL IMAGING
Entity Type:Organization
Organization Name:COMPLETE WOMAN MIDWIFERY & COMPLETE MEDICAL IMAGING
Other - Org Name:MANHATTAN HOME BIRTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MIDWIFE/OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:ALICE
Authorized Official - Last Name:PERRY
Authorized Official - Suffix:
Authorized Official - Credentials:CM, CPM
Authorized Official - Phone:973-226-2563
Mailing Address - Street 1:2 LINCOLN TER
Mailing Address - Street 2:
Mailing Address - City:CALDWELL
Mailing Address - State:NJ
Mailing Address - Zip Code:07006-5611
Mailing Address - Country:US
Mailing Address - Phone:973-226-2563
Mailing Address - Fax:
Practice Address - Street 1:2 LINCOLN TER
Practice Address - Street 2:
Practice Address - City:CALDWELL
Practice Address - State:NJ
Practice Address - Zip Code:07006-5611
Practice Address - Country:US
Practice Address - Phone:973-226-2563
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-28
Last Update Date:2009-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MW00000100176B00000X
NJ25MM00000700176B00000X
NYF0011431176B00000X
247200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes176B00000XOther Service ProvidersMidwifeGroup - Multi-Specialty
No247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, OtherGroup - Multi-Specialty