Healthcare Provider Details

I. General information

NPI: 1760396782
Provider Name (Legal Business Name): BEAR BROOK LACTATION & FEEDING CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/29/2026
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

727 ADAMS ST
HOBOKEN NJ
07030-3391
US

IV. Provider business mailing address

727 ADAMS ST
HOBOKEN NJ
07030-3391
US

V. Phone/Fax

Practice location:
  • Phone: 201-255-1563
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174N00000X
TaxonomyLactation Consultant (Non-RN)
License Number
License Number StateNULL

VIII. Authorized Official

Name: CHUL WON LEE
Title or Position: PRESIDENT
Credential: DMD
Phone: 917-755-1927