Organization
BANYAN TREE BIRTH CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ASHLEY J MECCARIELLO CNM (OWNER/PARTNER)
(914) 274-0791
Entity
Organization
Contact information
Practice address
88 MAPLE AVE, SMITHTOWN, NY 11787-3502
(631) 486-0832
(631) 504-0723
Mailing address
PO BOX 405, RIDGE, NY 11961-0405
(631) 486-0832
(631) 486-0832
Taxonomy
Speciality
Code
Description
License number
State
367A00000X
Advanced Practice Midwife
Primary
—
—
Other
Enumeration date
08/21/2023
Last updated
08/21/2023
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