Provider Demographics
NPI:1164305827
Name:SRIDASI LLC
Entity type:Organization
Organization Name:SRIDASI LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, LICENSED MIDWIFE
Authorized Official - Prefix:
Authorized Official - First Name:SUNDAY
Authorized Official - Middle Name:
Authorized Official - Last Name:LAW
Authorized Official - Suffix:
Authorized Official - Credentials:LM, CPM, CLC, CHES
Authorized Official - Phone:505-310-9358
Mailing Address - Street 1:1223 S SAINT FRANCIS DR STE D
Mailing Address - Street 2:
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87505-4053
Mailing Address - Country:US
Mailing Address - Phone:505-310-9358
Mailing Address - Fax:505-557-1081
Practice Address - Street 1:1223 S SAINT FRANCIS DR STE D
Practice Address - Street 2:
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87505-4053
Practice Address - Country:US
Practice Address - Phone:505-310-9358
Practice Address - Fax:505-557-1081
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-30
Last Update Date:2025-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes176B00000XOther Service ProvidersMidwifeGroup - Multi-Specialty
No374J00000XNursing Service Related ProvidersDoulaGroup - Multi-Specialty
No174N00000XOther Service ProvidersLactation Consultant, Non-RNGroup - Multi-Specialty