Provider Demographics
NPI:1285489880
Name:LITTLE MILKY WAY LLC
Entity type:Organization
Organization Name:LITTLE MILKY WAY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DANICE
Authorized Official - Middle Name:
Authorized Official - Last Name:MIRANDA
Authorized Official - Suffix:
Authorized Official - Credentials:IBCLC
Authorized Official - Phone:845-659-2715
Mailing Address - Street 1:44 COLUMBINE RD
Mailing Address - Street 2:
Mailing Address - City:PARAMUS
Mailing Address - State:NJ
Mailing Address - Zip Code:07652-2145
Mailing Address - Country:US
Mailing Address - Phone:908-460-9331
Mailing Address - Fax:
Practice Address - Street 1:44 COLUMBINE RD
Practice Address - Street 2:
Practice Address - City:PARAMUS
Practice Address - State:NJ
Practice Address - Zip Code:07652-2145
Practice Address - Country:US
Practice Address - Phone:845-659-2715
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-18
Last Update Date:2024-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RNGroup - Single Specialty