Provider Demographics
NPI:1629301338
Name:JEAN-PAUL, ELIZABETH (RN, IBCLC)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:JEAN-PAUL
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:PO BOX 1543
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10026-0973
Mailing Address - Country:US
Mailing Address - Phone:917-972-7729
Mailing Address - Fax:
Practice Address - Street 1:102 W 138TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10030-2300
Practice Address - Country:US
Practice Address - Phone:917-972-7729
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-13
Last Update Date:2009-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY108-87870163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant