Provider Demographics
NPI:1366244451
Name:CORPORATE LACTATION SERVICES, INC
Entity type:Organization
Organization Name:CORPORATE LACTATION SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NP
Authorized Official - Prefix:
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:GORMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:917-567-5260
Mailing Address - Street 1:1712 GREEN MOUNTAIN TPKE
Mailing Address - Street 2:
Mailing Address - City:CHESTER
Mailing Address - State:VT
Mailing Address - Zip Code:05143-8321
Mailing Address - Country:US
Mailing Address - Phone:802-875-5683
Mailing Address - Fax:
Practice Address - Street 1:1712 GREEN MOUNTAIN TPKE
Practice Address - Street 2:
Practice Address - City:CHESTER
Practice Address - State:VT
Practice Address - Zip Code:05143-8321
Practice Address - Country:US
Practice Address - Phone:802-875-5683
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CORPORATE LACTATION SERVICES, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-03-27
Last Update Date:2025-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty