Provider Demographics
NPI:1629868716
Name:MILKY WAY BREASTFEEDING MEDICINE OF CT, LLC
Entity type:Organization
Organization Name:MILKY WAY BREASTFEEDING MEDICINE OF CT, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:KATHLEEN
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:MARINELLI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:860-700-6700
Mailing Address - Street 1:88 RIDGEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:MIDDLEBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06762-2943
Mailing Address - Country:US
Mailing Address - Phone:860-700-6700
Mailing Address - Fax:
Practice Address - Street 1:39 NEW LONDON TPKE STE 301
Practice Address - Street 2:
Practice Address - City:GLASTONBURY
Practice Address - State:CT
Practice Address - Zip Code:06033-4256
Practice Address - Country:US
Practice Address - Phone:860-700-6700
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-12
Last Update Date:2025-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty