Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 174N00000X | Lactation Consultant | ALPP-312628 | NY |
NPI | 1053884759 |
---|---|
Provider Name | Tiffany Bueno |
First Address | Brooklyn, NY 11211-4643 |
Second Address | Brooklyn, NY 11211-4643 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/01/2019 |
Last Update Date | 04/01/2019 |