Provider Demographics
NPI:1255567418
Name:RIVER & MOUNTAIN WOMEN'S HEALTH
Entity type:Organization
Organization Name:RIVER & MOUNTAIN WOMEN'S HEALTH
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MIDWIFE
Authorized Official - Prefix:PROF
Authorized Official - First Name:SUSANRACHEL
Authorized Official - Middle Name:
Authorized Official - Last Name:CONDON
Authorized Official - Suffix:
Authorized Official - Credentials:LM
Authorized Official - Phone:845-256-5430
Mailing Address - Street 1:PO BOX 427
Mailing Address - Street 2:
Mailing Address - City:GARDINER
Mailing Address - State:NY
Mailing Address - Zip Code:12525-0427
Mailing Address - Country:US
Mailing Address - Phone:845-256-5430
Mailing Address - Fax:888-566-2334
Practice Address - Street 1:20 CALVIN BLVD
Practice Address - Street 2:
Practice Address - City:NEW PALTZ
Practice Address - State:NY
Practice Address - Zip Code:12561-2901
Practice Address - Country:US
Practice Address - Phone:845-256-5430
Practice Address - Fax:888-566-2334
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-02
Last Update Date:2010-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF000822176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes176B00000XOther Service ProvidersMidwifeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1669527644OtherNPI
1184845935OtherNPI