Provider Demographics
NPI:1588361802
Name:DECOSEY, LALONI (LPN IBCLC)
Entity type:Individual
Prefix:
First Name:LALONI
Middle Name:
Last Name:DECOSEY
Suffix:
Gender:F
Credentials:LPN IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1266 OXFORD AVE
Mailing Address - Street 2:
Mailing Address - City:PLAINFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07062-2234
Mailing Address - Country:US
Mailing Address - Phone:908-922-0508
Mailing Address - Fax:
Practice Address - Street 1:1266 OXFORD AVE
Practice Address - Street 2:
Practice Address - City:PLAINFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07062-2234
Practice Address - Country:US
Practice Address - Phone:908-922-0508
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-08
Last Update Date:2023-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
174N00000X
NJ26NP06253700164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN
No164W00000XNursing Service ProvidersLicensed Practical Nurse