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General NPI Number Information
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NPI Number | 1235548199
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Entity Type | Individual
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Provider Name | DAPHNE JORDAN-JOSEPH CDN
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Gender | Female
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Dates
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Enumeration Date | 08/05/2014
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Last Update Date | 04/06/2015
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Provider Practice Location Address
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Address Line | 271 NORTH AVE SUITE 111 ULTIMATE CONSULTATION
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City | NEW ROCHELLE
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State | NY
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Zip | 10801
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Country | US
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Telephone | 914-235-3674
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Fax | 914-633-1584
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Provider Business Mailing Address
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Address Line | 363 ELTON STREET
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City | BROOKLYN
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State | NY
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Zip | 11208
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Country | US
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Telephone | 347-788-7350
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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 | 133N00000X
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Taxonomy Name | Nutritionist
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License Number | 133N00000X
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License Number State | NY
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