Provider Demographics
NPI:1629878103
Name:BEJCEK, BETH (IBCLC)
Entity type:Individual
Prefix:
First Name:BETH
Middle Name:
Last Name:BEJCEK
Suffix:
Gender:X
Credentials:IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:94 RICHARDSON ST
Mailing Address - Street 2:
Mailing Address - City:BATH
Mailing Address - State:ME
Mailing Address - Zip Code:04530-3004
Mailing Address - Country:US
Mailing Address - Phone:207-200-7317
Mailing Address - Fax:
Practice Address - Street 1:94 RICHARDSON ST
Practice Address - Street 2:
Practice Address - City:BATH
Practice Address - State:ME
Practice Address - Zip Code:04530-3004
Practice Address - Country:US
Practice Address - Phone:207-200-7317
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-14
Last Update Date:2025-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEL-13385174N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN