Provider Demographics
NPI:1780935247
Name:ESSON, TAMI LYN (MA, IBCLC)
Entity type:Individual
Prefix:MRS
First Name:TAMI
Middle Name:LYN
Last Name:ESSON
Suffix:
Gender:F
Credentials:MA, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:112 GREENE ST APT 4
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10012-3866
Mailing Address - Country:US
Mailing Address - Phone:917-640-0877
Mailing Address - Fax:
Practice Address - Street 1:112 GREENE ST APT 4
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10012-3866
Practice Address - Country:US
Practice Address - Phone:917-640-0877
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-25
Last Update Date:2012-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY11268143174N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN