Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 176B00000X | Midwife | 25MW00001800 | NJ |
NPI | 1063857886 |
---|---|
Provider Name | Judith Elissa Norman |
First Address | Bronx, NY 10463-2026 |
Second Address | Bronx, NY 10463-2026 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/05/2013 |
Last Update Date | 07/05/2013 |