Provider Demographics
NPI:1124487608
Name:WALSH, ALLISON J (IBCLC, LCCE)
Entity type:Individual
Prefix:
First Name:ALLISON
Middle Name:J
Last Name:WALSH
Suffix:
Gender:F
Credentials:IBCLC, LCCE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 STUYVESANT OVAL APT 1C
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10009-1935
Mailing Address - Country:US
Mailing Address - Phone:212-674-2998
Mailing Address - Fax:
Practice Address - Street 1:17 STUYVESANT OVAL APT 1C
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10009-1935
Practice Address - Country:US
Practice Address - Phone:212-674-2998
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-12
Last Update Date:2016-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN