Provider Demographics
NPI:1952676306
Name:DRAPER, CORNELIA V (IBCLC)
Entity Type:Individual
Prefix:MRS
First Name:CORNELIA
Middle Name:V
Last Name:DRAPER
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 1:33 JACKSON AVE
Mailing Address - Street 2:
Mailing Address - City:CHATHAM
Mailing Address - State:NJ
Mailing Address - Zip Code:07928-2618
Mailing Address - Country:US
Mailing Address - Phone:973-507-9249
Mailing Address - Fax:
Practice Address - Street 1:33 JACKSON AVE
Practice Address - Street 2:
Practice Address - City:CHATHAM
Practice Address - State:NJ
Practice Address - Zip Code:07928-2618
Practice Address - Country:US
Practice Address - Phone:973-507-9249
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-19
Last Update Date:2012-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA10522247174N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN