Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 176B00000X | Midwife | 25ME00063500 | NJ |
NPI | 1134635311 |
---|---|
Provider Name | Kathleen Meehan-Hart |
First Address | Clifton, NJ 07013-3638 |
Second Address | Paterson, NJ 07514-1524 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/12/2017 |
Last Update Date | 17/03/2018 |