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General NPI Number Information
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NPI Number | 1861156689
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Entity Type | Organization
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Legal Business Name | KINDRED NUTRITION LLC
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Dates
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Enumeration Date | 10/27/2021
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Last Update Date | 10/27/2021
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Provider Practice Location Address
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Address Line | 130 PEMBROKE DR
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City | PALM BEACH GARDENS
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State | FL
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Zip | 33418-4611
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Country | US
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Telephone | 201-693-5358
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Fax |
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Provider Business Mailing Address
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Address Line | 130 PEMBROKE DR
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City | PALM BEACH GARDENS
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State | FL
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Zip | 33418-4611
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Country | US
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Telephone | 201-693-5358
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | LEA M RIFKIN
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Credential | MS, RD, LDN, RYT
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Telephone | 201-693-5358
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number |
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License Number State |
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