Healthcare Provider Details

I. General information

NPI: 1881490456
Provider Name (Legal Business Name): MARIBEL GARCIA RN, IBCLC, LCCE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/24/2025
Last Update Date: 02/24/2025
Certification Date: 02/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 PELHAM PKWY S
BRONX NY
10461-1138
US

IV. Provider business mailing address

39 33RD ST
COPIAGUE NY
11726-1810
US

V. Phone/Fax

Practice location:
  • Phone: 718-918-1400
  • Fax:
Mailing address:
  • Phone: 646-912-2465
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WL0100X
TaxonomyLactation Consultant (Registered Nurse)
License Number614422
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: