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NPI Code Detail

MEDICARE: LAURA AIMEE GIBOFSKY MS, RD, CDN

MEDICARE:   LAURA AIMEE GIBOFSKY  MS, RD, CDN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1133V00000XRegistered Dietitian007587-1NY

General Provider Information

NPI Number : 1285085415
Entity Type Code : Individual
Provider Name (Legal Business Name) : LAURA AIMEE GIBOFSKY MS, RD, CDN
Provider Business Mailing Address
First Line : 425 E 79TH ST APT 15E
Second Line :
City : NEW YORK
State : NY
Zip : 10075-1010
Country : US
Telephone Number : 917-587-8537
Fax Number :
Provider Business Practice Location Address
First Line : 425 E 79TH ST
Second Line : APT 15E
City : NEW YORK
State : NY
Zip : 10075-1037
Country : US
Telephone Number : 917-405-0386
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/29/2016
Last Update Date : 06/03/2021

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Directions to “ LAURA AIMEE GIBOFSKY MS, RD, CDN” Practice Location

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