Provider Demographics
NPI:1619260635
Name:LEVINE, RACHEL SUSAN (BFA, IBCLC, RLC)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:SUSAN
Last Name:LEVINE
Suffix:
Gender:F
Credentials:BFA, IBCLC, RLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:53 E GARFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:ATLANTIC HIGHLANDS
Mailing Address - State:NJ
Mailing Address - Zip Code:07716-1427
Mailing Address - Country:US
Mailing Address - Phone:732-670-6611
Mailing Address - Fax:
Practice Address - Street 1:53 E GARFIELD AVE
Practice Address - Street 2:
Practice Address - City:ATLANTIC HIGHLANDS
Practice Address - State:NJ
Practice Address - Zip Code:07716-1427
Practice Address - Country:US
Practice Address - Phone:732-670-6611
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-24
Last Update Date:2011-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN