Healthcare Provider Details

I. General information

NPI: 1417521956
Provider Name (Legal Business Name): ENJOY FOOD. ENJOY LIFE.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/19/2021
Last Update Date: 05/19/2021
Certification Date: 05/19/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

185 W PARK AVE APT 208
LONG BEACH NY
11561-3328
US

IV. Provider business mailing address

185 W PARK AVE APT 208
LONG BEACH NY
11561-3328
US

V. Phone/Fax

Practice location:
  • Phone: 212-729-0327
  • Fax:
Mailing address:
  • Phone: 212-729-0327
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number
License Number State

VIII. Authorized Official

Name: MRS. NICOLE RODRIGUEZ
Title or Position: OWNER
Credential: RDN
Phone: 212-729-0327