Provider Demographics
NPI:1043637242
Name:THOMPSON, CYNTHIA (RN, IBCLC)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:
Last Name:THOMPSON
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 1:35 NORTH CRES
Mailing Address - Street 2:
Mailing Address - City:MAPLEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07040-2707
Mailing Address - Country:US
Mailing Address - Phone:973-762-5501
Mailing Address - Fax:
Practice Address - Street 1:35 NORTH CRES
Practice Address - Street 2:
Practice Address - City:MAPLEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07040-2707
Practice Address - Country:US
Practice Address - Phone:973-762-5501
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-03-25
Last Update Date:2014-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJL-47663163WL0100X
NJ26NR11269100163WM0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant
No163WM0102XNursing Service ProvidersRegistered NurseMaternal Newborn