Provider Demographics
NPI:1629428990
Name:BISCHOFF, CYNTHIA (IBCLC)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:
Last Name:BISCHOFF
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 1:1016 ALLEN AVE
Mailing Address - Street 2:
Mailing Address - City:WEST RIVER
Mailing Address - State:MD
Mailing Address - Zip Code:20778-2225
Mailing Address - Country:US
Mailing Address - Phone:240-800-6455
Mailing Address - Fax:
Practice Address - Street 1:1016 ALLEN AVE
Practice Address - Street 2:
Practice Address - City:WEST RIVER
Practice Address - State:MD
Practice Address - Zip Code:20778-2225
Practice Address - Country:US
Practice Address - Phone:240-800-6455
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-17
Last Update Date:2016-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDL-94778174N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN