Provider Demographics
NPI:1467019794
Name:ZEFERINO, SUSANNA (RN, IBCLC)
Entity Type:Individual
Prefix:
First Name:SUSANNA
Middle Name:
Last Name:ZEFERINO
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 1:831 MAGIE AVE
Mailing Address - Street 2:
Mailing Address - City:ELIZABETH
Mailing Address - State:NJ
Mailing Address - Zip Code:07208-1459
Mailing Address - Country:US
Mailing Address - Phone:908-414-5295
Mailing Address - Fax:
Practice Address - Street 1:313 STATE ST
Practice Address - Street 2:
Practice Address - City:PERTH AMBOY
Practice Address - State:NJ
Practice Address - Zip Code:08861-4128
Practice Address - Country:US
Practice Address - Phone:732-376-1188
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-22
Last Update Date:2019-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NR21310700163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant