Healthcare Provider Details

I. General information

NPI: 1194028985
Provider Name (Legal Business Name): ROBYN B LITTMAN R.D.,C.D.N.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/16/2010
Last Update Date: 12/16/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

55 HARROGATE ST
LIDO BEACH NY
11561-5012
US

IV. Provider business mailing address

55 HARROGATE ST
LIDO BEACH NY
11561-5012
US

V. Phone/Fax

Practice location:
  • Phone: 516-225-7171
  • Fax: 516-431-9856
Mailing address:
  • Phone: 516-225-7171
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number004174
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: