Individual
YEKATERINA SPIVAK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RPA-C, IBCLC
Contact information
Practice address
302 WELSH RD, HUNTINGDON VALLEY, PA 19006-6423
(973) 797-9790
Mailing address
302 WELSH RD, HUNTINGDON VALLEY, PA 19006-6423
(646) 404-6591
Taxonomy
Speciality
Code
Description
License number
State
174N00000X
Lactation Consultant (Non-RN)
Primary
L56767
NY
363A00000X
Physician Assistant
0148861
NY
363A00000X
Physician Assistant
25MP00342600
NJ
363AM0700X
Medical Physician Assistant
MA063450
PA
Other
Enumeration date
03/02/2012
Last updated
03/15/2023
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