Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 174N00000X | Lactation Consultant | L-84469 | NY |
NPI | 1255795712 |
---|---|
Provider Name | Mrs. Viktoriya Ilina-Levy |
First Address | Mineola, NY 11501-3713 |
Second Address | Mineola, NY 11501-3713 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/04/2016 |
Last Update Date | 11/04/2016 |