Active NPI
Emily Marianne Sullivan, CLC
- Lactation Consultant (Non-RN)
- Westwood, NJ
National Provider Identifier
1053788554
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Lactation Consultant (Non-RN)
- License
- 225649
- Practice address
- 636 Lincoln Blvd
Westwood, NJ 07675-3433 - Phone
- (551) 404-4854
- NPI assigned
- Aug 31, 2015
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Lactation Consultant (Non-RN) | 174N00000X | 225649 | NJ | Primary |
Addresses
Primary practice location
636 Lincoln Blvd
Westwood, NJ 07675-3433
Mailing address
636 Lincoln Blvd
Westwood, NJ 07675-3433
Phone (551) 404-4854
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 225649 | NJ | MD | Lactation Consultant (Non-RN) |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1440979200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1440979200000",
"number": "1053788554",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "636 LINCOLN BLVD",
"city": "WESTWOOD",
"state": "NJ",
"postal_code": "076753433",
"telephone_number": "551-404-4854"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "636 LINCOLN BLVD",
"city": "WESTWOOD",
"state": "NJ",
"postal_code": "076753433",
"telephone_number": "551-404-4854"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SULLIVAN",
"first_name": "EMILY",
"middle_name": "MARIANNE",
"name_prefix": "Mrs.",
"credential": "CLC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-08-31",
"last_updated": "2015-08-31",
"status": "A"
},
"taxonomies": [
{
"code": "174N00000X",
"taxonomy_group": "",
"desc": "Lactation Consultant, Non-RN",
"state": "NJ",
"license": "225649",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Westwood, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.