Provider Demographics
NPI:1568728012
Name:SCHWARTZ-GRUNIN, BONNIE (IBCLC)
Entity Type:Individual
Prefix:MS
First Name:BONNIE
Middle Name:
Last Name:SCHWARTZ-GRUNIN
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 1:2230 E 60TH PL
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11234-6404
Mailing Address - Country:US
Mailing Address - Phone:347-262-1058
Mailing Address - Fax:
Practice Address - Street 1:2230 E 60TH PL
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11234-6404
Practice Address - Country:US
Practice Address - Phone:347-262-1058
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-10
Last Update Date:2012-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA19110704174N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN