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General NPI Number Information
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NPI Number | 1194137851
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Entity Type | Organization
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Legal Business Name | JEANNINE ANDRE-BURNS NUTRITION, INC.
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Dates
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Enumeration Date | 05/28/2014
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Last Update Date | 09/10/2014
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Provider Practice Location Address
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Address Line | 1530 UNION ST
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City | BROOKLYN
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State | NY
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Zip | 11213-4501
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Country | US
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Telephone | 860-305-4425
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Fax |
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Provider Business Mailing Address
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Address Line | 1530 UNION ST
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City | BROOKLYN
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State | NY
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Zip | 11213-4501
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Country | US
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Telephone | 860-305-4425
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Fax |
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Authorized Official
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Title or Position | DIEITITIAN/NUTRITIONIST
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Name | JEANNINE ANDRE-BURNS
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Credential | CNS, CDN
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Telephone | 860-305-4425
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133N00000X
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Taxonomy Name | Nutritionist
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License Number | 007904
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License Number State | NY
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