Provider Demographics
NPI:1336431444
Name:CHARPENTIER, ERICA (IBCLC)
Entity type:Individual
Prefix:
First Name:ERICA
Middle Name:
Last Name:CHARPENTIER
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 1:103 GROVE ST
Mailing Address - Street 2:
Mailing Address - City:MOUNT KISCO
Mailing Address - State:NY
Mailing Address - Zip Code:10549-2942
Mailing Address - Country:US
Mailing Address - Phone:347-623-5504
Mailing Address - Fax:
Practice Address - Street 1:103 GROVE ST
Practice Address - Street 2:
Practice Address - City:MOUNT KISCO
Practice Address - State:NY
Practice Address - Zip Code:10549-2942
Practice Address - Country:US
Practice Address - Phone:347-623-5504
Practice Address - Fax:914-801-9404
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-08
Last Update Date:2025-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYL-19555174N00000X
NYP138815106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No174N00000XOther Service ProvidersLactation Consultant, Non-RN