Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 176B00000X | Midwife | F000977 | NY |
NPI | 1053445031 |
---|---|
Provider Name | Ms. Leah Marinelli |
First Address | Suffern, NY 10901-1708 |
Second Address | Suffern, NY 10901-1708 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/03/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
02383017 | (05) | NY |