Individual
MRS. LENORA S MESIBOV
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
IBCLC
Contact information
Practice address
168 WASHINGTON ST., TAPPAN, NY 10983
(845) 365-3917
Mailing address
168 WASHINGTON ST, TAPPAN, NY 10983-2510
(845) 365-3917
Taxonomy
Speciality
Code
Description
License number
State
174N00000X
Lactation Consultant (Non-RN)
Primary
10991724
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10991724
LACTATION CONSULTANT, NON-RN CLASSIFICATION,
VA
Enumeration date
04/11/2011
Last updated
04/11/2011
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