Healthcare Provider Details

I. General information

NPI: 1790125342
Provider Name (Legal Business Name): INNA TSINKER MS, RD, CDN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/27/2013
Last Update Date: 06/27/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27 BEACH VIEW AVENUE
STATEN ISLAND NY
10306
US

IV. Provider business mailing address

27 BEACH VIEW AVENUE
STATEN ISLAND NY
10306
US

V. Phone/Fax

Practice location:
  • Phone: 718-556-1155
  • Fax: 718-556-6555
Mailing address:
  • Phone: 718-556-1155
  • Fax: 718-556-6555

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code133N00000X
TaxonomyNutritionist
License Number8083782
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number874345
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: