Amy Noell Cavallo, RN, IBCLC

Individual provider Active NPI Lactation Consultant (Registered Nurse) · Selkirk, NY

NPI 1023680402 · NPPES record last updated Jul 14, 2021

Key facts

NPI
1023680402
Entity type
Individual (NPI type 1)
Primary specialty
Lactation Consultant (Registered Nurse) 163WL0100X
License
64377601 (NY)
Practice address
241 Nasner LN
Selkirk, NY 12158-1236
Phone
(949) 280-9002
NPI assigned
Jul 14, 2021
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
64377601NYMDLactation Consultant (Registered Nurse)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Lactation Consultant (Registered Nurse) 163WL0100X 64377601 NY Yes

Addresses

Primary practice location

241 Nasner LN
Selkirk, NY 12158-1236

Mailing address

241 Nasner LN
Selkirk, NY 12158-1236
Phone (949) 280-9002

Other providers in Selkirk, NY

All providers in Selkirk, NY · Lactation Consultant (Registered Nurse) in New York

Sources for this page

Verify at the official NPI Registry.