Provider Demographics
NPI:1396357661
Name:MOOMENS, HAYAT (RN,IBCLC)
Entity Type:Individual
Prefix:MS
First Name:HAYAT
Middle Name:
Last Name:MOOMENS
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 1:2514 WEST ST APT 3B
Mailing Address - Street 2:
Mailing Address - City:UNION CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07087-3988
Mailing Address - Country:US
Mailing Address - Phone:718-809-5147
Mailing Address - Fax:
Practice Address - Street 1:2514 WEST ST APT 3B
Practice Address - Street 2:
Practice Address - City:UNION CITY
Practice Address - State:NJ
Practice Address - Zip Code:07087-3988
Practice Address - Country:US
Practice Address - Phone:718-809-5147
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-18
Last Update Date:2020-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NR21201600163WL0100X
NY694455163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant