Provider Demographics
NPI:1508120593
Name:BREASTFEEDING SUPPORT, INC.
Entity Type:Organization
Organization Name:BREASTFEEDING SUPPORT, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LACTATION CONSULTANT
Authorized Official - Prefix:MS
Authorized Official - First Name:AYELET
Authorized Official - Middle Name:
Authorized Official - Last Name:KAZNELSON
Authorized Official - Suffix:
Authorized Official - Credentials:CLC, IBCLC
Authorized Official - Phone:917-620-4068
Mailing Address - Street 1:311 W 95TH ST
Mailing Address - Street 2:APT. 2C
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10025-6103
Mailing Address - Country:US
Mailing Address - Phone:917-620-4068
Mailing Address - Fax:
Practice Address - Street 1:311 W 95TH ST
Practice Address - Street 2:APT. 2C
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10025-6103
Practice Address - Country:US
Practice Address - Phone:917-620-4068
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-25
Last Update Date:2012-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY10420788174N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RNGroup - Single Specialty