Provider Demographics
NPI:1194935841
Name:GORCENSKI, LORETTA P (RNC, IBCLC)
Entity type:Individual
Prefix:MRS
First Name:LORETTA
Middle Name:P
Last Name:GORCENSKI
Suffix:
Gender:F
Credentials:RNC, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 LATHAM HILL RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:CT
Mailing Address - Zip Code:06237-1408
Mailing Address - Country:US
Mailing Address - Phone:860-228-4194
Mailing Address - Fax:860-228-1428
Practice Address - Street 1:14 LATHAM HILL RD
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:CT
Practice Address - Zip Code:06237-1408
Practice Address - Country:US
Practice Address - Phone:860-228-4194
Practice Address - Fax:860-228-1428
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CTR37687163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant