Healthcare Provider Details

I. General information

NPI: 1043617012
Provider Name (Legal Business Name): JOANNA CASCIONE RN, IBCLC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/19/2014
Last Update Date: 11/19/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1701 ALBEMARLE RD APT B3
BROOKLYN NY
11226-4621
US

IV. Provider business mailing address

1701 ALBEMARLE RD APT B3
BROOKLYN NY
11226-4621
US

V. Phone/Fax

Practice location:
  • Phone: 646-468-4028
  • Fax:
Mailing address:
  • Phone: 646-468-4028
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WL0100X
TaxonomyLactation Consultant (Registered Nurse)
License Number636350
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: