MEDICARE: DR. SVETLANA GERTSENSHTEYN PHD, MPH, 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
1	133V00000X	Registered Dietitian	000667-1	NY
2	133V00000X	Registered Dietitian	816548	NY

General Provider Information

NPI Number	:	1902294168
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SVETLANA GERTSENSHTEYN PHD, MPH, RD, CDN

Provider Business Mailing Address
First Line	:	1245 E 35TH ST FL 2
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11210-4821
Country	:	US
Telephone Number	:	917-615-6534
Fax Number	:

Provider Business Practice Location Address
First Line	:	1245 E 35TH ST FL 2
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11210-4821
Country	:	US
Telephone Number	:	917-615-6534
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/22/2014
Last Update Date	:	02/22/2023

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