Provider Demographics
NPI:1205245537
Name:KOWALSKI, LESLIE R (PHD, IBCLC)
Entity type:Individual
Prefix:
First Name:LESLIE
Middle Name:R
Last Name:KOWALSKI
Suffix:
Gender:F
Credentials:PHD, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 JEFFERS RD
Mailing Address - Street 2:
Mailing Address - City:PLAINSBORO
Mailing Address - State:NJ
Mailing Address - Zip Code:08536-1901
Mailing Address - Country:US
Mailing Address - Phone:908-715-5454
Mailing Address - Fax:
Practice Address - Street 1:7 JEFFERS RD
Practice Address - Street 2:
Practice Address - City:PLAINSBORO
Practice Address - State:NJ
Practice Address - Zip Code:08536-1901
Practice Address - Country:US
Practice Address - Phone:908-715-5454
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-12
Last Update Date:2015-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJL-25205174N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN