Provider Demographics
NPI:1396167771
Name:O'CONNOR, LEIGH ANNE (IBCLC)
Entity type:Individual
Prefix:
First Name:LEIGH
Middle Name:ANNE
Last Name:O'CONNOR
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 1:10 STUYVESANT OVAL
Mailing Address - Street 2:5B
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10009-2420
Mailing Address - Country:US
Mailing Address - Phone:917-596-3646
Mailing Address - Fax:
Practice Address - Street 1:10 STUYVESANT OVAL
Practice Address - Street 2:5B
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10009-2420
Practice Address - Country:US
Practice Address - Phone:917-596-3646
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-20
Last Update Date:2014-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY174N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN