Healthcare Provider Details

I. General information

NPI: 1457419970
Provider Name (Legal Business Name): CLARA CHEUNG NUTRITION CONSULTING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/05/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

41 ELIZABETH ST ROOM 501
NEW YORK NY
10013-4637
US

IV. Provider business mailing address

41 ELIZABETH ST ROOM 501
NEW YORK NY
10013-4637
US

V. Phone/Fax

Practice location:
  • Phone: 212-966-3829
  • Fax: 212-966-2885
Mailing address:
  • Phone: 212-966-3829
  • Fax: 212-966-2885

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133N00000X
TaxonomyNutritionist
License Number4928429
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number833435
License Number StateIL

VIII. Authorized Official

Name: MS. CLARA CHEUNG
Title or Position: NUTRITIONIST
Credential: R.D.
Phone: 212-966-3829