Provider Demographics
NPI:1033553326
Name:IFAN, ZANENGE F (MPH, IBCLC)
Entity Type:Individual
Prefix:
First Name:ZANENGE
Middle Name:F
Last Name:IFAN
Suffix:
Gender:F
Credentials:MPH, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:43 WHITE MEADOW RD
Mailing Address - Street 2:
Mailing Address - City:HILLSBOROUGH
Mailing Address - State:NJ
Mailing Address - Zip Code:08844-1619
Mailing Address - Country:US
Mailing Address - Phone:908-432-4378
Mailing Address - Fax:
Practice Address - Street 1:43 WHITE MEADOW RD
Practice Address - Street 2:
Practice Address - City:HILLSBOROUGH
Practice Address - State:NJ
Practice Address - Zip Code:08844-1619
Practice Address - Country:US
Practice Address - Phone:908-432-4378
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-17
Last Update Date:2013-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA19714020174N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN