MEDICARE: BRITTNEY GRACE PARRIS MS RD CDN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	133V00000X	Registered Dietitian	86108791
2	133N00000X	Nutritionist	009696	NY

General Provider Information

NPI Number	:	1295349488
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRITTNEY GRACE PARRIS MS RD CDN

Provider Business Mailing Address
First Line	:	236 MACDONOUGH ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11233-1007
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	367 SAINT MARKS AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11238-2268
Country	:	US
Telephone Number	:	917-652-6201
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/03/2020
Last Update Date	:	01/24/2024

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