Healthcare Provider Details

I. General information

NPI: 1659293439
Provider Name (Legal Business Name): ELIZABETH SCHEPPKE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/27/2026
Last Update Date: 07/27/2026
Certification Date: 07/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25 TEN EYCK ST APT 2A
BROOKLYN NY
11206-7646
US

IV. Provider business mailing address

25 TEN EYCK ST APT 2A
BROOKLYN NY
11206-7646
US

V. Phone/Fax

Practice location:
  • Phone: 503-990-9681
  • Fax:
Mailing address:
  • Phone: 503-990-9681
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174N00000X
TaxonomyLactation Consultant (Non-RN)
License Number332793
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: