Provider Demographics
NPI:1396168209
Name:FLOWER CHILD KRISTIN MECOCCI WALICKI RN, IBCLC, PLLC
Entity type:Organization
Organization Name:FLOWER CHILD KRISTIN MECOCCI WALICKI RN, IBCLC, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KRISTIN
Authorized Official - Middle Name:
Authorized Official - Last Name:MECOCCI WALICKI
Authorized Official - Suffix:
Authorized Official - Credentials:RN, IBCLC
Authorized Official - Phone:845-551-7267
Mailing Address - Street 1:108 MAUREEN DR
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:NY
Mailing Address - Zip Code:10940-6681
Mailing Address - Country:US
Mailing Address - Phone:845-551-7267
Mailing Address - Fax:
Practice Address - Street 1:108 MAUREEN DR
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:NY
Practice Address - Zip Code:10940-6681
Practice Address - Country:US
Practice Address - Phone:845-551-7267
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-28
Last Update Date:2014-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY22562216163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation ConsultantGroup - Multi-Specialty