Healthcare Provider Details

I. General information

NPI: 1942126529
Provider Name (Legal Business Name): GRACE ROSA-BIAN IBCLC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/26/2026
Last Update Date: 06/26/2026
Certification Date: 06/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1355 OLD YORK RD STE 101
ABINGTON PA
19001-3413
US

IV. Provider business mailing address

407 GORDON RD
AMBLER PA
19002-5208
US

V. Phone/Fax

Practice location:
  • Phone: 215-886-2433
  • Fax:
Mailing address:
  • Phone: 267-342-2173
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174N00000X
TaxonomyLactation Consultant (Non-RN)
License NumberL-322189
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: