Individual
DONNA B. KIMICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
IBCLC, RLC
Contact information
Practice address
232 LAKESHORE BLVD, MASSAPEQUA PARK, NY 11762-3005
(516) 799-7911
Mailing address
232 LAKESHORE BLVD, MASSAPEQUA PARK, NY 11762-3005
Taxonomy
Speciality
Code
Description
License number
State
174N00000X
Lactation Consultant (Non-RN)
Primary
10421257
NY
Other
Enumeration date
11/01/2011
Last updated
11/01/2011
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