Healthcare Provider Details

I. General information

NPI: 1578953170
Provider Name (Legal Business Name): BREASTFEEDING HELPER PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/03/2015
Last Update Date: 02/03/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 OXFORD VALLEY RD SUITE 1405
YARDLEY PA
19067-7706
US

IV. Provider business mailing address

17 SHELLFLOWER RD
LEVITTOWN PA
19056-1707
US

V. Phone/Fax

Practice location:
  • Phone: 267-879-5000
  • Fax: 267-393-4500
Mailing address:
  • Phone: 267-879-5000
  • Fax: 267-393-4500

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WL0100X
TaxonomyLactation Consultant (Registered Nurse)
License Number256115L
License Number StatePA

VIII. Authorized Official

Name: GAIL DITTES
Title or Position: OWNER / PROVIDER
Credential: RN IBCLC
Phone: 267-879-5000