Individual
LISA FORTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
IBCLC
Contact information
Practice address
146 N 7TH ST APT 1, BROOKLYN, NY 11249-2974
(646) 260-5595
Mailing address
146 N 7TH ST APT 1, BROOKLYN, NY 11249-2974
Taxonomy
Speciality
Code
Description
License number
State
174N00000X
Lactation Consultant (Non-RN)
Primary
11294773
NY
Other
Enumeration date
01/02/2013
Last updated
01/02/2013
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