Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 174N00000X | Lactation Consultant |
NPI | 1144789561 |
---|---|
Provider Name | Marcia Santiago |
First Address | Staten Island, NY 10301-3734 |
Second Address | Staten Island, NY 10301-3734 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/03/2019 |
Last Update Date | 26/10/2021 |