Individual
TAHITI STARSHIP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CM
Contact information
Practice address
760 BROADWAY, BROOKLYN, NY 11206-5383
(718) 963-8000
Mailing address
760 BROADWAY, BROOKLYN, NY 11206-5383
(718) 963-8000
Taxonomy
Speciality
Code
Description
License number
State
176B00000X
Midwife
Primary
001813
NY
Other
Enumeration date
12/03/2017
Last updated
11/12/2019
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