Provider Demographics
NPI:1669819082
Name:WALSH, KAREN A (IBCLC)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:A
Last Name:WALSH
Suffix:
Gender:F
Credentials:IBCLC
Other - Prefix:
Other - First Name:KAREN
Other - Middle Name:A
Other - Last Name:MCGRATTY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:IBCLC
Mailing Address - Street 1:2389 SCHILLER AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH BELLMORE
Mailing Address - State:NY
Mailing Address - Zip Code:11710-2142
Mailing Address - Country:US
Mailing Address - Phone:718-869-1377
Mailing Address - Fax:
Practice Address - Street 1:2389 SCHILLER AVE
Practice Address - Street 2:
Practice Address - City:NORTH BELLMORE
Practice Address - State:NY
Practice Address - Zip Code:11710
Practice Address - Country:US
Practice Address - Phone:718-869-1377
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-24
Last Update Date:2018-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYL-25692174N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN