Individual
KATHERINE KONCELIK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CBD, CPD, CLC
Contact information
Practice address
112 JEFFERSON ST, EAST ISLIP, NY 11730
(631) 581-1066
Mailing address
112 JEFFERSON ST, EAST ISLIP, NY 11730-1826
(631) 581-1066
Taxonomy
Speciality
Code
Description
License number
State
174N00000X
Lactation Consultant (Non-RN)
Primary
—
—
374J00000X
Doula
—
NY
Other
Enumeration date
03/04/2010
Last updated
10/29/2018
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