Provider Demographics
NPI:1679789226
Name:PASAKARNIS, KATHLEEN FALLON (IBCLC)
Entity type:Individual
Prefix:MRS
First Name:KATHLEEN
Middle Name:FALLON
Last Name:PASAKARNIS
Suffix:
Gender:F
Credentials:IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:98 WOODLAND DR
Mailing Address - Street 2:
Mailing Address - City:SOUTH WINDSOR
Mailing Address - State:CT
Mailing Address - Zip Code:06074-2336
Mailing Address - Country:US
Mailing Address - Phone:860-644-4191
Mailing Address - Fax:
Practice Address - Street 1:98 WOODLAND DR
Practice Address - Street 2:
Practice Address - City:SOUTH WINDSOR
Practice Address - State:CT
Practice Address - Zip Code:06074-2336
Practice Address - Country:US
Practice Address - Phone:860-644-4191
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist