Healthcare Provider Details

I. General information

NPI: 1912342262
Provider Name (Legal Business Name): ALLEGRA NOELLE GATTI ZEMEL RN, IBCLC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/30/2013
Last Update Date: 04/30/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 W 77TH ST APT 6E
NEW YORK NY
10024-6644
US

IV. Provider business mailing address

201 W 77TH ST APT 6E
NEW YORK NY
10024-6644
US

V. Phone/Fax

Practice location:
  • Phone: 917-771-0739
  • Fax:
Mailing address:
  • Phone: 917-771-0739
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174N00000X
TaxonomyLactation Consultant (Non-RN)
License Number10725715
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: