MEDICARE: ASHLEY BAUMOHL MPH, RD, CDN, CNSC

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

General Provider Information

NPI Number	:	1811576804
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ASHLEY BAUMOHL MPH, RD, CDN, CNSC

Provider Business Mailing Address
First Line	:	121A W 20TH ST
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10011-3601
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	121A W 20TH ST
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10011-3601
Country	:	US
Telephone Number	:	212-505-6663
Fax Number	:

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

Provider Enumeration Date	:	04/06/2021
Last Update Date	:	04/06/2021

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