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General NPI Number Information
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NPI Number | 1811326564
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Entity Type | Individual
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Provider Name | GAIL DITTES RN IBCLC
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Gender | Female
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Dates
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Enumeration Date | 11/04/2013
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Last Update Date | 10/02/2014
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Provider Practice Location Address
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Address Line | 17 SHELLFLOWER RD
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City | LEVITTOWN
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State | PA
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Zip | 19056-1707
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Country | US
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Telephone | 267-241-1432
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Fax |
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Provider Business Mailing Address
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Address Line | 17 SHELLFLOWER RD
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City | LEVITTOWN
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State | PA
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Zip | 19056-1707
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Country | US
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Telephone | 267-879-5000
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Fax | 267-393-4500
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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 | 163WL0100X
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Taxonomy Name | Lactation Consultant (Registered Nurse)
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License Number | L-46563
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License Number State | PA
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