Healthcare Provider Details

I. General information

NPI: 1093659625
Provider Name (Legal Business Name): ELENA MILENKOVSKA RUSSELL IBCLC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/15/2026
Last Update Date: 04/15/2026
Certification Date: 04/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

498 OLD FARM RD
FRANKLIN MA
02038-1136
US

IV. Provider business mailing address

498 OLD FARM RD
FRANKLIN MA
02038-1136
US

V. Phone/Fax

Practice location:
  • Phone: 617-880-9677
  • Fax: 617-880-9677
Mailing address:
  • Phone: 617-880-9677
  • Fax: 617-880-9677

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WL0100X
TaxonomyLactation Consultant (Registered Nurse)
License NumberL-319035
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: