Healthcare Provider Details

I. General information

NPI: 1750008363
Provider Name (Legal Business Name): NESTLE & CRADLE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/24/2022
Last Update Date: 10/24/2022
Certification Date: 10/24/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

32 BRUCE AVE
YONKERS NY
10705-3201
US

IV. Provider business mailing address

PO BOX 1383
YONKERS NY
10702-1383
US

V. Phone/Fax

Practice location:
  • Phone: 914-525-7945
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133NN1002X
TaxonomyNutrition Education Nutritionist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code174N00000X
TaxonomyLactation Consultant (Non-RN)
License Number
License Number State

VIII. Authorized Official

Name: BIANCA CORNELIUS
Title or Position: OWNER
Credential: RDN, IBCLC
Phone: 914-525-7945