Provider Demographics
NPI:1073112298
Name:CANTATORE, ERICA JEAN (RN, IBCLC, LCCE)
Entity Type:Individual
Prefix:MRS
First Name:ERICA
Middle Name:JEAN
Last Name:CANTATORE
Suffix:
Gender:F
Credentials:RN, IBCLC, LCCE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:36 KNICKERBOCKER RD
Mailing Address - Street 2:
Mailing Address - City:DEMAREST
Mailing Address - State:NJ
Mailing Address - Zip Code:07627-1919
Mailing Address - Country:US
Mailing Address - Phone:201-906-5691
Mailing Address - Fax:
Practice Address - Street 1:36 KNICKERBOCKER RD
Practice Address - Street 2:
Practice Address - City:DEMAREST
Practice Address - State:NJ
Practice Address - Zip Code:07627-1919
Practice Address - Country:US
Practice Address - Phone:201-906-5691
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-19
Last Update Date:2020-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NR15729400163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation ConsultantGroup - Multi-Specialty