Individual
PHYLLIS LYNN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNM
Contact information
Practice address
6208 4TH AVE, BROOKLYN, NY 11220-4616
(718) 283-8867
(718) 283-8468
Mailing address
967 48TH ST, BROOKLYN, NY 11219-2919
(718) 283-6813
(718) 283-8468
Taxonomy
Speciality
Code
Description
License number
State
176B00000X
Midwife
Primary
F000129-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
07793568
—
NY
Enumeration date
06/28/2005
Last updated
07/26/2013
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