Provider Demographics
NPI:1033483631
Name:SWIDERSKI, DAWN DIANE (RN,IBCLC)
Entity Type:Individual
Prefix:MS
First Name:DAWN
Middle Name:DIANE
Last Name:SWIDERSKI
Suffix:
Gender:F
Credentials:RN,IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 MICHELE CT
Mailing Address - Street 2:
Mailing Address - City:SEWELL
Mailing Address - State:NJ
Mailing Address - Zip Code:08080-2724
Mailing Address - Country:US
Mailing Address - Phone:856-693-4837
Mailing Address - Fax:
Practice Address - Street 1:4 MICHELE CT
Practice Address - Street 2:
Practice Address - City:SEWELL
Practice Address - State:NJ
Practice Address - Zip Code:08080-2724
Practice Address - Country:US
Practice Address - Phone:856-693-4837
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-28
Last Update Date:2012-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NR04897600163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant