MEDICARE: CLAIRE CERNIGLIA RN, IBCLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163WL0100X	Lactation Consultant (Registered Nurse)	RN95390029	CA
2	163WL0100X	Lactation Consultant (Registered Nurse)	1670572	CO

General Provider Information

NPI Number	:	1477386647
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CLAIRE CERNIGLIA RN, IBCLC

Provider Business Mailing Address
First Line	:	1127 E DEL MAR BLVD APT 315
Second Line	:
City	:	PASADENA
State	:	CA
Zip	:	91106-3438
Country	:	US
Telephone Number	:	301-785-3352
Fax Number	:

Provider Business Practice Location Address
First Line	:	1127 E DEL MAR BLVD APT 315
Second Line	:
City	:	PASADENA
State	:	CA
Zip	:	91106-3438
Country	:	US
Telephone Number	:	301-785-3352
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/23/2024
Last Update Date	:	08/23/2024

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