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NPI 1649556903

NPI 1649556903 : JULIE BETH CARDONICK IBCLC, CD (DONA) : TEANECK, NJ

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General NPI Number Information
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    NPI Number           |    1649556903
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    Entity Type          |    Individual 
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    Provider Name        |    JULIE BETH CARDONICK IBCLC, CD (DONA)
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    10/31/2011
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    Last Update Date     |    10/31/2011
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Provider Practice Location Address
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    Address Line         |    991 RICHARD CT 
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    City                 |    TEANECK
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    State                |    NJ
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    Zip                  |    07666-5511
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    Country              |    US
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    Telephone            |    201-837-5910
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    991 RICHARD CT 
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    City                 |    TEANECK
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    State                |    NJ
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    Zip                  |    07666-5511
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    Country              |    US
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    Telephone            |    201-837-5910
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    Fax                  |    
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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       |    107-26311
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    License Number State |    NJ
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Taxonomy #2
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    Taxonomy Code        |    374J00000X
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    Taxonomy Name        |    Doula
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    License Number       |    
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    License Number State |    
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