Provider Demographics
NPI:1346594629
Name:MCFADDEN, HEATHER (LACTATION CONSULTANT)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:
Last Name:MCFADDEN
Suffix:
Gender:F
Credentials:LACTATION CONSULTANT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:523 W 121ST ST # 1
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10027-5901
Mailing Address - Country:US
Mailing Address - Phone:212-665-3899
Mailing Address - Fax:
Practice Address - Street 1:523 W 121ST ST # 1
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10027-5901
Practice Address - Country:US
Practice Address - Phone:212-665-3899
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-11-07
Last Update Date:2012-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY11233942174N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN