Provider Demographics
NPI:1417464165
Name:BELONOGOFF, CATHERINE (IBCLC)
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:
Last Name:BELONOGOFF
Suffix:
Gender:F
Credentials:IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:61 GORDONHURST AVE
Mailing Address - Street 2:
Mailing Address - City:MONTCLAIR
Mailing Address - State:NJ
Mailing Address - Zip Code:07043-2415
Mailing Address - Country:US
Mailing Address - Phone:646-465-0163
Mailing Address - Fax:
Practice Address - Street 1:61 GORDONHURST AVE
Practice Address - Street 2:
Practice Address - City:MONTCLAIR
Practice Address - State:NJ
Practice Address - Zip Code:07043-2415
Practice Address - Country:US
Practice Address - Phone:646-465-0163
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-03
Last Update Date:2020-07-29
Deactivation Date:2019-05-14
Deactivation Code:
Reactivation Date:2020-07-29
Provider Licenses
StateLicense IDTaxonomies
NJL-100380174N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN