Basic Information
Provider Information
NPI: 1912117565
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: DUFFY
FirstName: MARIA
MiddleName: ANN
NamePrefix: MRS.
NameSuffix:  
Credential: C.N.M.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 22581
Address2:  
City: NEW YORK
State: NY
PostalCode: 100872581
CountryCode: US
TelephoneNumber: 6104824795
FaxNumber: 8565283117
Practice Location
Address1: 599 W STATE ST STE 301
Address2:  
City: DOYLESTOWN
State: PA
PostalCode: 189012567
CountryCode: US
TelephoneNumber: 2154892066
FaxNumber: 2154821166
Other Information
ProviderEnumerationDate: 05/23/2007
LastUpdateDate: 08/25/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 08/25/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
367A00000XMWOO8542LPAY Physician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife 

No ID Information.


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