Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 174N00000X | Lactation Consultant | 165071 | NJ |
NPI | 1053950568 |
---|---|
Provider Name | Mrs. Angelina Itri |
First Address | Hammonton, NJ 08037-2857 |
Second Address | Collingswood, NJ 08108-1900 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 31/12/2019 |
Last Update Date | 31/12/2019 |