Provider Demographics
NPI:1588247159
Name:LABOMBARD LACTATION SERVICES, LLC
Entity type:Organization
Organization Name:LABOMBARD LACTATION SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LACTATION COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:ELISE
Authorized Official - Last Name:LABOMBARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:315-224-3404
Mailing Address - Street 1:2 GLENDALE AVE
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12208-3107
Mailing Address - Country:US
Mailing Address - Phone:315-224-4049
Mailing Address - Fax:
Practice Address - Street 1:2 GLENDALE AVE
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12208-3107
Practice Address - Country:US
Practice Address - Phone:315-224-4049
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-03
Last Update Date:2021-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RNGroup - Single Specialty