| NPI | 1720449184 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RENA A BRUCKMAN Nutritionist 914-320-3197 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: CT 001294) |
| Enumeration Date | 2016-03-14 |
| Last Update Date | 2016-03-14 |