Provider Demographics
NPI:1225779622
Name:BEECH TREE LACTATION LLC
Entity Type:Organization
Organization Name:BEECH TREE LACTATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KATHRYN
Authorized Official - Middle Name:
Authorized Official - Last Name:M MCLAUGHLIN
Authorized Official - Suffix:
Authorized Official - Credentials:IBCLC
Authorized Official - Phone:551-804-8496
Mailing Address - Street 1:216 SYLVAN RD
Mailing Address - Street 2:
Mailing Address - City:BLOOMFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07003-5547
Mailing Address - Country:US
Mailing Address - Phone:551-804-8496
Mailing Address - Fax:
Practice Address - Street 1:216 SYLVAN RD
Practice Address - Street 2:
Practice Address - City:BLOOMFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07003-5547
Practice Address - Country:US
Practice Address - Phone:551-804-8496
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-07
Last Update Date:2022-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RNGroup - Single Specialty