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General NPI Number Information
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NPI Number | 1093241986
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Entity Type | Individual
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Provider Name | SORAYYA KASSAMALI RICKICKI LM, CM, IBCLC
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Gender | Female
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Dates
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Enumeration Date | 05/11/2017
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Last Update Date | 10/21/2024
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Provider Practice Location Address
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Address Line | 434 E 10TH ST APT 4
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City | NEW YORK
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State | NY
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Zip | 10009-4256
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Country | US
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Telephone | 917-783-9561
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Fax | 888-690-3168
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Provider Business Mailing Address
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Address Line | 434 E 10TH ST APT 4
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City | NEW YORK
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State | NY
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Zip | 10009-4256
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Country | US
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Telephone | 917-783-9561
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Fax | 888-810-7628
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174N00000X
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Taxonomy Name | Lactation Consultant (Non-RN)
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License Number | L-109824
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 367A00000X
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Taxonomy Name | Advanced Practice Midwife
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License Number | F001941
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License Number State | NY
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