=====================================================
General NPI Number Information
=====================================================
NPI Number | 1174476139
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | MILKFACE BREASTFEEDING
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/18/2026
-----------------------------------------------------
Last Update Date | 02/18/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 100 QUARRY RD STE 105
-----------------------------------------------------
City | HAMBURG
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 07419-1339
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 973-604-5472
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 9 DENNIS DR
-----------------------------------------------------
City | NEWTON
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 07860-6034
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 973-604-5472
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | JACQULYN POTTER
-----------------------------------------------------
Credential | BA, IBCLC
-----------------------------------------------------
Telephone | 973-604-5472
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 174N00000X
-----------------------------------------------------
Taxonomy Name | Lactation Consultant (Non-RN)
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------