| NPI | 1154758969 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAUREN ASHLEY MINCHEN Registered Dietitian 646-745-7034 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: NY 1049273) |
| Additional Taxonomies | 261QM2500X Clinic/Center, Medical Specialty (Licence: NY 007792-1) |
| Enumeration Date | 2013-10-11 |
| Last Update Date | 2013-10-11 |