Healthcare Provider Details

I. General information

NPI: 1679337638
Provider Name (Legal Business Name): SARA KAHN NUTRITION, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/09/2024
Last Update Date: 02/09/2024
Certification Date: 02/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

165 FINCH RD
NORTH SALEM NY
10560-1502
US

IV. Provider business mailing address

165 FINCH RD
NORTH SALEM NY
10560-1502
US

V. Phone/Fax

Practice location:
  • Phone: 201-245-4813
  • Fax:
Mailing address:
  • Phone: 201-245-4813
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133N00000X
TaxonomyNutritionist
License Number
License Number State

VIII. Authorized Official

Name: SARA KAHN
Title or Position: MEMBER
Credential: CNS, CDN
Phone: 201-245-4813