Cherida Lally, CNM, LM
Individual provider
Active NPI
Midwife · Stamford, CT
NPI 1306922158 · NPPES record last updated Jul 11, 2019
Key facts
- NPI
- 1306922158
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Midwife 176B00000X
- License
- F000707-1 (NY)
- Practice address
- 999 Summer St
Stamford, CT 06905-5546
- Phone
- (203) 353-9099
- NPI assigned
- Oct 27, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|
| I20160428000394 |
NY |
Order and Referring Only - Certified Nurse Midwife (CNM) |
4385823475 |
|
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Certified Nurse Midwife
State licenses
| License | State | Type | Specialty |
|---|
| F000707-1 | NY | MD | Midwife |
Practice roles
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|
| Midwife |
176B00000X |
F000707-1 |
NY |
Yes |
Addresses
Primary practice location
999 Summer St
Stamford, CT 06905-5546
Mailing address
999 Summer St
Stamford, CT 06905-5546
Phone (203) 353-9099
Other identifiers
| Identifier | Type | State | Issuer |
|---|
| 01975277 | Medicaid | NY | |