Provider Demographics
NPI:1285908517
Name:SILBERGER, SUSAN T (IBCLC)
Entity type:Individual
Prefix:
First Name:SUSAN
Middle Name:T
Last Name:SILBERGER
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 1:3687 WOODBRIDGE LN N
Mailing Address - Street 2:
Mailing Address - City:WANTAGH
Mailing Address - State:NY
Mailing Address - Zip Code:11793-1523
Mailing Address - Country:US
Mailing Address - Phone:516-650-1634
Mailing Address - Fax:
Practice Address - Street 1:3687 WOODBRIDGE LN N
Practice Address - Street 2:
Practice Address - City:WANTAGH
Practice Address - State:NY
Practice Address - Zip Code:11793-1523
Practice Address - Country:US
Practice Address - Phone:516-650-1634
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-05
Last Update Date:2012-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY174N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN