Bridget Epiphanie, CLC, PCD

Primary specialty

Lactation Consultant (Non-RN)Taxonomy code 174N00000X

License

32729 Issued in MA

Practice address

12 Peggy Ann Rd
Queensbury, NY 12804-9076

Phone

(518) 796-4558

NPI assigned

Mar 26, 2012

Last updated

Mar 26, 2012By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1332720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1332720000000",
    "number": "1477829364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 PEGGY ANN RD",
            "city": "QUEENSBURY",
            "state": "NY",
            "postal_code": "128049076",
            "telephone_number": "518-796-4558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 PEGGY ANN RD",
            "city": "QUEENSBURY",
            "state": "NY",
            "postal_code": "128049076",
            "telephone_number": "518-796-4558"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EPIPHANIE",
        "first_name": "BRIDGET",
        "credential": "CLC, PCD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-03-26",
        "last_updated": "2012-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174N00000X",
            "taxonomy_group": "",
            "desc": "Lactation Consultant, Non-RN",
            "state": "MA",
            "license": "32729",
            "primary": true
        },
        {
            "code": "374J00000X",
            "taxonomy_group": "",
            "desc": "Doula",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Lactation Consultant (Non-RN) in Queensbury, NY
• Providers in Queensbury, NY by specialty
• Lactation Consultant (Non-RN) in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2012; 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.