Provider Demographics
NPI:1679046528
Name:EATON, CYNTHIA JEAN (RN BSN IBCLC)
Entity type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:JEAN
Last Name:EATON
Suffix:
Gender:F
Credentials:RN BSN IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:65 BLEECKER ST APT 1B
Mailing Address - Street 2:
Mailing Address - City:GREENWICH
Mailing Address - State:NY
Mailing Address - Zip Code:12834-1229
Mailing Address - Country:US
Mailing Address - Phone:518-415-7801
Mailing Address - Fax:
Practice Address - Street 1:65 BLEECKER ST APT 1B
Practice Address - Street 2:
Practice Address - City:GREENWICH
Practice Address - State:NY
Practice Address - Zip Code:12834-1229
Practice Address - Country:US
Practice Address - Phone:518-415-7801
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-03
Last Update Date:2019-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYL-148769163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant