Provider Demographics
NPI:1760894653
Name:FISCHER-ROTHMAN, CHRISTINE (PHD, IBCLC, CLC)
Entity Type:Individual
Prefix:DR
First Name:CHRISTINE
Middle Name:
Last Name:FISCHER-ROTHMAN
Suffix:
Gender:F
Credentials:PHD, IBCLC, CLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:82 DUNSTER RD
Mailing Address - Street 2:
Mailing Address - City:JAMAICA PLAIN
Mailing Address - State:MA
Mailing Address - Zip Code:02130-2732
Mailing Address - Country:US
Mailing Address - Phone:617-447-8411
Mailing Address - Fax:
Practice Address - Street 1:82 DUNSTER RD
Practice Address - Street 2:
Practice Address - City:JAMAICA PLAIN
Practice Address - State:MA
Practice Address - Zip Code:02130-2732
Practice Address - Country:US
Practice Address - Phone:617-447-8411
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-27
Last Update Date:2015-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAALPP-204105174N00000X
IBCLC L-82067174N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN