Provider Demographics
NPI:1093083925
Name:MACHLIN, LISA (RN, IBCLC)
Entity Type:Individual
Prefix:MRS
First Name:LISA
Middle Name:
Last Name:MACHLIN
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 1:555 ELLIS HOLLOW CREEK RD
Mailing Address - Street 2:
Mailing Address - City:ITHACA
Mailing Address - State:NY
Mailing Address - Zip Code:14850-9623
Mailing Address - Country:US
Mailing Address - Phone:607-539-7178
Mailing Address - Fax:
Practice Address - Street 1:555 ELLIS HOLLOW CREEK RD
Practice Address - Street 2:
Practice Address - City:ITHACA
Practice Address - State:NY
Practice Address - Zip Code:14850-9623
Practice Address - Country:US
Practice Address - Phone:607-539-7178
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-07
Last Update Date:2011-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY534910-1163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant