Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 174N00000X | Lactation Consultant | ALPP-43765 | NY |
NPI | 1306258215 |
---|---|
Provider Name | Grace Veras |
First Address | Brooklyn, NY 11218-5371 |
Second Address | Brooklyn, NY 11218-5371 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/05/2014 |
Last Update Date | 27/05/2014 |