Healthcare Provider Details

I. General information

NPI: 1376932814
Provider Name (Legal Business Name): RIKKI SEDAKA KINITSKY RN, IBCLC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: RIKKI SEDAKA RN, IBCLC

II. Dates (important events)

Enumeration Date: 01/21/2015
Last Update Date: 08/25/2025
Certification Date: 08/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

810 ADAMS ST
DENVER CO
80206-3934
US

IV. Provider business mailing address

810 ADAMS ST
DENVER CO
80206-3934
US

V. Phone/Fax

Practice location:
  • Phone: 201-873-1596
  • Fax:
Mailing address:
  • Phone: 201-873-1596
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WL0100X
TaxonomyLactation Consultant (Registered Nurse)
License Number299322
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: