Provider Demographics
NPI:1821493917
Name:BLUMBERG, RACHEL (IBCLC)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:
Last Name:BLUMBERG
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 1:17208 PICKWICK DRIVE
Mailing Address - Street 2:
Mailing Address - City:PURCELLVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:20132-3100
Mailing Address - Country:US
Mailing Address - Phone:703-409-2486
Mailing Address - Fax:
Practice Address - Street 1:17208 PICKWICK DR
Practice Address - Street 2:
Practice Address - City:PURCELLVILLE
Practice Address - State:VA
Practice Address - Zip Code:20132-3100
Practice Address - Country:US
Practice Address - Phone:703-409-2486
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-31
Last Update Date:2016-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN