Stephanie Jean Pruchnik, LPN, IBCLC
Individual provider Active NPI Lactation Consultant (Non-RN) · New Milford, CT
NPI 1669878260 · NPPES record last updated Nov 19, 2014
Key facts
- NPI
- 1669878260
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Lactation Consultant (Non-RN) 174N00000X
- License
- L-60874 (CT)
- Practice address
- 120 Park Lane Rd
Suite A101
New Milford, CT 06776-2444 - Phone
- (203) 417-1693
- NPI assigned
- Nov 7, 2014
- 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 |
|---|---|---|---|
| L-60874 | CT | MD | Lactation Consultant (Non-RN) |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Lactation Consultant (Non-RN) | 174N00000X | L-60874 | CT | Yes |
Addresses
Primary practice location
120 Park Lane Rd
Suite A101
New Milford, CT 06776-2444
Mailing address
21 Pickett District Rd
New Milford, CT 06776-4412
Phone (203) 417-1693
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All providers in New Milford, CT · Lactation Consultant (Non-RN) in Connecticut
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 19, 2014. 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.