Provider Demographics
NPI:1497643985
Name:KEDZIORA, DANIELLE HELENE (IBCLC)
Entity type:Individual
Prefix:
First Name:DANIELLE
Middle Name:HELENE
Last Name:KEDZIORA
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 1:5533 HAVEN AVE
Mailing Address - Street 2:
Mailing Address - City:OCEAN CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:08226-1269
Mailing Address - Country:US
Mailing Address - Phone:610-772-6199
Mailing Address - Fax:
Practice Address - Street 1:5533 HAVEN AVE
Practice Address - Street 2:
Practice Address - City:OCEAN CITY
Practice Address - State:NJ
Practice Address - Zip Code:08226-1269
Practice Address - Country:US
Practice Address - Phone:610-772-6199
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-25
Last Update Date:2025-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN332157L163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant