Healthcare Provider Details

I. General information

NPI: 1851627137
Provider Name (Legal Business Name): PAULA ANN FITT RN, BSN, IBCLC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/21/2009
Last Update Date: 10/21/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26 MANOR DR
NEWTON NJ
07860-2740
US

IV. Provider business mailing address

26 MANOR DR
NEWTON NJ
07860-2740
US

V. Phone/Fax

Practice location:
  • Phone: 973-219-8325
  • Fax: 973-579-9575
Mailing address:
  • Phone: 973-219-8325
  • Fax: 973-579-9575

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WL0100X
TaxonomyLactation Consultant (Registered Nurse)
License Number26NO11743200
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: