Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 174N00000X | Lactation Consultant | ALPP-208931 | NY |
NPI | 1003202227 |
---|---|
Provider Name | Ms. Sankofa Ra |
First Address | New Rochelle, NY 10801-5901 |
Second Address | New Rochelle, NY 10801-5901 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/04/2015 |
Last Update Date | 14/04/2015 |