Individual provider Active NPI

Stephanie Rodriguez-Ninman, RN, IBCLC

  • Lactation Consultant (Registered Nurse)
  • Brooklyn, NY
National Provider Identifier
1184403743
Registry record updated Sep 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Lactation Consultant (Registered Nurse)Taxonomy code 163WL0100X
License
659955 Issued in NY
Practice address
170 Tillary St Apt 506
Brooklyn, NY 11201-2060
Phone
(612) 310-0368
NPI assigned
Sep 25, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 25, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Inpatient Obstetric Registered Nurse 163WX0003X 659955 NY
Lactation Consultant (Registered Nurse) 163WL0100X 659955 NY Primary

Addresses

Primary practice location

170 Tillary St Apt 506
Brooklyn, NY 11201-2060

Mailing address

170 Tillary St Apt 506
Brooklyn, NY 11201-2060
Phone (612) 310-0368

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
659955NYMDLactation Consultant (Registered Nurse)

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1695600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695600000000",
    "number": "1184403743",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "170 TILLARY ST APT 506",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112012060",
            "telephone_number": "612-310-0368"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "170 TILLARY ST APT 506",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112012060",
            "telephone_number": "612-310-0368"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ-NINMAN",
        "first_name": "STEPHANIE",
        "credential": "RN, IBCLC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-09-25",
        "last_updated": "2023-09-25",
        "certification_date": "2023-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WX0003X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Obstetric, Inpatient",
            "state": "NY",
            "license": "659955",
            "primary": false
        },
        {
            "code": "163WL0100X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Lactation Consultant",
            "state": "NY",
            "license": "659955",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.