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General NPI Number Information
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NPI Number | 1023118528
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Entity Type | Individual
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Provider Name | MANDI PEK MS, RD, CSP, CDN
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Gender | Female
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Dates
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Enumeration Date | 09/24/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1 GUSTAVE L LEVY PL 1190 FIFTH AVE
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City | NEW YORK
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State | NY
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Zip | 10029-6500
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Country | US
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Telephone | 212-241-7916
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Fax |
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Provider Business Mailing Address
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Address Line | 135 E 50TH ST APT 2E
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City | NEW YORK
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State | NY
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Zip | 10022-7514
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Country | US
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Telephone | 212-241-7916
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133VN1004X
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Taxonomy Name | Pediatric Nutrition Registered Dietitian
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License Number | 005669
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License Number State | NY
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