Healthcare Provider Details

I. General information

NPI: 1467019794
Provider Name (Legal Business Name): SUSANNA ZEFERINO RN, IBCLC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/22/2019
Last Update Date: 04/20/2026
Certification Date: 04/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

831 MAGIE AVE
ELIZABETH NJ
07208-1459
US

IV. Provider business mailing address

831 MAGIE AVE
ELIZABETH NJ
07208-1459
US

V. Phone/Fax

Practice location:
  • Phone: 908-414-5295
  • Fax:
Mailing address:
  • Phone: 908-414-5295
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WL0100X
TaxonomyLactation Consultant (Registered Nurse)
License Number26NR21310700
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: