Provider Demographics
NPI:1285841874
Name:CAREY, MARY SULLIVAN (RN,IBCLC)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:SULLIVAN
Last Name:CAREY
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 1:14 PINEBROOK DR
Mailing Address - Street 2:
Mailing Address - City:EASTHAMPTON
Mailing Address - State:MA
Mailing Address - Zip Code:01027-9723
Mailing Address - Country:US
Mailing Address - Phone:413-529-2200
Mailing Address - Fax:413-529-2203
Practice Address - Street 1:14 PINEBROOK DR
Practice Address - Street 2:
Practice Address - City:EASTHAMPTON
Practice Address - State:MA
Practice Address - Zip Code:01027-9723
Practice Address - Country:US
Practice Address - Phone:413-529-2200
Practice Address - Fax:413-529-2203
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA105--21980163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant