Provider Demographics
NPI:1487251427
Name:FRESH NUTRITION COUNSELING CORP
Entity type:Organization
Organization Name:FRESH NUTRITION COUNSELING CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL/OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:DIMA
Authorized Official - Middle Name:WALID
Authorized Official - Last Name:SALHOOBI
Authorized Official - Suffix:
Authorized Official - Credentials:RD
Authorized Official - Phone:914-426-3896
Mailing Address - Street 1:2025 CENTRAL PARK AVE STE 2A
Mailing Address - Street 2:
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10710-2427
Mailing Address - Country:US
Mailing Address - Phone:914-426-3896
Mailing Address - Fax:
Practice Address - Street 1:2025 CENTRAL PARK AVE STE 2A
Practice Address - Street 2:
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10710-2427
Practice Address - Country:US
Practice Address - Phone:914-426-3896
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-02
Last Update Date:2020-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty