Healthcare Provider Details

I. General information

NPI: 1821135880
Provider Name (Legal Business Name): LAURA BETH ROSENBLATT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/31/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

275 7TH AVENUE 3RD FLOOR
NEW YORK NY
10001
US

IV. Provider business mailing address

275 7TH AVENUE 3RD FLOOR
NEW YORK NY
10001
US

V. Phone/Fax

Practice location:
  • Phone: 646-660-9999
  • Fax: 646-778-3450
Mailing address:
  • Phone: 646-660-9999
  • Fax: 646-778-3450

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133N00000X
TaxonomyNutritionist
License Number0062461
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number0062461
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: