Healthcare Provider Details

I. General information

NPI: 1770404758
Provider Name (Legal Business Name): RAISING MOTHERHOOD, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/23/2026
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3 GRADY LN
CORAM NY
11727-3018
US

IV. Provider business mailing address

3 GRADY LN
CORAM NY
11727-3018
US

V. Phone/Fax

Practice location:
  • Phone: 631-295-7635
  • Fax:
Mailing address:
  • Phone: 631-295-7635
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: APRIL MARIE IPPOLITO
Title or Position: FOUNDER/IBCLC
Credential: IBCLC
Phone: 631-295-7635