Brielle Lynn Petrella, CLC
Individual provider Active NPI Lactation Consultant (Non-RN) · Allentown, NJ
NPI 1629420195 · NPPES record last updated Jul 8, 2016
Key facts
- NPI
- 1629420195
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Lactation Consultant (Non-RN) 174N00000X
- License
- 237865 (PA)
- Practice address
- 74 Ellisdale Rd
Allentown, NJ 08501-1508 - Phone
- (609) 218-0892
- NPI assigned
- Jul 8, 2016
- 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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 237865 | PA | MD | Lactation Consultant (Non-RN) |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Lactation Consultant (Non-RN) | 174N00000X | 237865 | PA | Yes |
Addresses
Primary practice location
74 Ellisdale Rd
Allentown, NJ 08501-1508
Mailing address
74 Ellisdale Rd
Allentown, NJ 08501-1508
Phone (609) 218-0892
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- Kelly A Quaste
- Alexis R Rasmussen
- Sheila Rios Riehle
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All providers in Allentown, NJ · Lactation Consultant (Non-RN) in New Jersey
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.