Healthcare Provider Details

I. General information

NPI: 1508528076
Provider Name (Legal Business Name): FOOD IS YOUR MEDICINE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/12/2021
Last Update Date: 10/12/2021
Certification Date: 10/12/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1150 E 34TH ST
BROOKLYN NY
11210-4122
US

IV. Provider business mailing address

1150 E 34TH ST
BROOKLYN NY
11210-4122
US

V. Phone/Fax

Practice location:
  • Phone: 917-601-7728
  • Fax: 855-895-8482
Mailing address:
  • Phone: 917-601-7728
  • Fax: 855-895-8482

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: RHONDA NEOLA CAMBRIDGE-PHILLIP
Title or Position: PHYSICIAN/WELLNESS COACH
Credential: MD, MPH, HC
Phone: 917-601-7728