Provider Demographics
NPI:1063284370
Name:LEBRON, GURAMRIT K (IBCLC)
Entity type:Individual
Prefix:
First Name:GURAMRIT
Middle Name:K
Last Name:LEBRON
Suffix:
Gender:F
Credentials:IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:86 MOUNTAIN VIEW DR
Mailing Address - Street 2:
Mailing Address - City:HOLMES
Mailing Address - State:NY
Mailing Address - Zip Code:12531-5452
Mailing Address - Country:US
Mailing Address - Phone:646-416-2877
Mailing Address - Fax:
Practice Address - Street 1:1000 DEAN ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11238-3381
Practice Address - Country:US
Practice Address - Phone:646-450-0875
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-30
Last Update Date:2025-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYL-316439174N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN