Provider Demographics
NPI:1487482238
Name:NUTRITION WITH REBECCA, PLLC
Entity type:Organization
Organization Name:NUTRITION WITH REBECCA, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED DIETITIAN
Authorized Official - Prefix:
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:
Authorized Official - Last Name:TOLAN
Authorized Official - Suffix:
Authorized Official - Credentials:MS, RDN, CDN
Authorized Official - Phone:516-965-0634
Mailing Address - Street 1:353 E 83RD ST APT 20L
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10028-4341
Mailing Address - Country:US
Mailing Address - Phone:516-965-0634
Mailing Address - Fax:631-850-6107
Practice Address - Street 1:353 E 83RD ST
Practice Address - Street 2:APT 20L
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10028
Practice Address - Country:US
Practice Address - Phone:516-965-0634
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-23
Last Update Date:2024-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty