Provider Demographics
NPI:1396125639
Name:MANSOOR, CAROLE (RN,CPNP,IBCLC)
Entity type:Individual
Prefix:MISS
First Name:CAROLE
Middle Name:
Last Name:MANSOOR
Suffix:
Gender:F
Credentials:RN,CPNP,IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 BLAKESLEE ST
Mailing Address - Street 2:
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:02138-3328
Mailing Address - Country:US
Mailing Address - Phone:857-998-9145
Mailing Address - Fax:
Practice Address - Street 1:16 BLAKESLEE ST
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:02138-3328
Practice Address - Country:US
Practice Address - Phone:857-998-9145
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-02
Last Update Date:2015-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN