Provider Demographics
NPI:1316298169
Name:YANKOWSKI, CATHY RALEIGH (RN, IBCLC)
Entity type:Individual
Prefix:
First Name:CATHY
Middle Name:RALEIGH
Last Name:YANKOWSKI
Suffix:
Gender:F
Credentials:RN, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26 MORRIS RD.
Mailing Address - Street 2:
Mailing Address - City:PROSPECT
Mailing Address - State:CT
Mailing Address - Zip Code:06712-1436
Mailing Address - Country:US
Mailing Address - Phone:203-758-4400
Mailing Address - Fax:
Practice Address - Street 1:11 PLANK RD
Practice Address - Street 2:
Practice Address - City:PROSPECT
Practice Address - State:CT
Practice Address - Zip Code:06712-1436
Practice Address - Country:US
Practice Address - Phone:203-758-4400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-19
Last Update Date:2014-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT11271132163WL0100X
CTR36983374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant
No374J00000XNursing Service Related ProvidersDoula