Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 174N00000X | Lactation Consultant | L-108789 | NJ |
NPI | 1255970711 |
---|---|
Provider Name | Karen Borja |
First Address | Neptune, NJ 07753-4955 |
Second Address | Neptune, NJ 07753-4955 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/01/2020 |
Last Update Date | 02/01/2020 |