Provider Demographics
NPI:1033637160
Name:NASTASSIA K. ENTERPRISES
Entity Type:Organization
Organization Name:NASTASSIA K. ENTERPRISES
Other - Org Name:LATCH BREASTFEEDING AND LACTATION SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/IBCLC
Authorized Official - Prefix:
Authorized Official - First Name:NASTASSIA
Authorized Official - Middle Name:K
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:MSN, RNC, IBCLC
Authorized Official - Phone:973-488-7975
Mailing Address - Street 1:36 RANDOLPH PL
Mailing Address - Street 2:
Mailing Address - City:WEST ORANGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07052-4808
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:485 PARK AVE
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:NJ
Practice Address - Zip Code:07050-1721
Practice Address - Country:US
Practice Address - Phone:973-488-7975
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-09
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NR1590800163WL0100X, 163WM0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation ConsultantGroup - Single Specialty
No163WM0102XNursing Service ProvidersRegistered NurseMaternal NewbornGroup - Single Specialty