Healthcare Provider Details

I. General information

NPI: 1659795763
Provider Name (Legal Business Name): LACTATION SERVICES OF NEW YORK, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/10/2014
Last Update Date: 02/10/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

65 PARK TER E C27
NEW YORK NY
10034-1447
US

IV. Provider business mailing address

65 PARK TER E C27
NEW YORK NY
10034-1447
US

V. Phone/Fax

Practice location:
  • Phone: 212-567-1112
  • Fax:
Mailing address:
  • Phone:
  • 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: BEVERLY SOLOW
Title or Position: PRESIDENT
Credential:
Phone: 212-567-1112