Healthcare Provider Details

I. General information

NPI: 1639637242
Provider Name (Legal Business Name): LINDA LEE FLORENCE STOIBER RN, IBCLC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/04/2019
Last Update Date: 03/04/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

127 NORTH ST
BATAVIA NY
14020-1631
US

IV. Provider business mailing address

127 NORTH ST
BATAVIA NY
14020-1631
US

V. Phone/Fax

Practice location:
  • Phone: 585-344-5480
  • Fax: 585-344-7468
Mailing address:
  • Phone: 585-344-5480
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WL0100X
TaxonomyLactation Consultant (Registered Nurse)
License Number417300
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: