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General NPI Number Information
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NPI Number | 1902127053
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Entity Type | Organization
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Legal Business Name | YOURS NUTRITIONALLY LLC
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Dates
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Enumeration Date | 06/11/2010
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Last Update Date | 01/26/2016
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Provider Practice Location Address
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Address Line | 1170 OCEAN PKWY APT 7F
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City | BROOKLYN
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State | NY
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Zip | 11230-4053
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Country | US
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Telephone | 718-377-6516
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Fax |
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Provider Business Mailing Address
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Address Line | 1170 OCEAN PKWY APT 7F
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City | BROOKLYN
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State | NY
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Zip | 11230-4053
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Country | US
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Telephone | 718-377-6516
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Fax |
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Authorized Official
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Title or Position | REGISTERED DIETITIAN
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Name | MS. RAIZY WEINREB
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Credential | RD
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Telephone | 732-803-5310
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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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