Healthcare Provider Details

I. General information

NPI: 1285842047
Provider Name (Legal Business Name): SOPHIA ASLANIS RD, CDN, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/17/2007
Last Update Date: 04/20/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

250 W 57TH ST STE 1513
NEW YORK NY
10107-1509
US

IV. Provider business mailing address

250 W 57TH ST STE 1513
NEW YORK NY
10107-1509
US

V. Phone/Fax

Practice location:
  • Phone: 212-245-0575
  • Fax: 212-245-6131
Mailing address:
  • Phone: 212-245-0575
  • Fax: 212-245-6131

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133NN1002X
TaxonomyNutrition Education Nutritionist
License Number005526-1
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number005526-1
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code133VN1004X
TaxonomyPediatric Nutrition Registered Dietitian
License Number005526-1
License Number StateNY
# 4
Primary TaxonomyN
Taxonomy Code133VN1006X
TaxonomyMetabolic Nutrition Registered Dietitian
License Number005526-1
License Number StateNY

VIII. Authorized Official

Name: MS. SOPHIA ASLANIS
Title or Position: FOUNDER
Credential: RD,CDN
Phone: 212-245-0575