Provider Demographics
NPI:1619517083
Name:CHRISTOPHER, CASSANDRA (IBCLC, CLC)
Entity Type:Individual
Prefix:
First Name:CASSANDRA
Middle Name:
Last Name:CHRISTOPHER
Suffix:
Gender:F
Credentials:IBCLC, CLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:79 HAMILTON PL APT 14
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10031-6850
Mailing Address - Country:US
Mailing Address - Phone:203-512-7000
Mailing Address - Fax:
Practice Address - Street 1:79 HAMILTON PL APT 14
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10031-6850
Practice Address - Country:US
Practice Address - Phone:203-512-7000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-13
Last Update Date:2021-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY313552174N00000X
L-304004174N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN