Provider Demographics
NPI:1003125691
Name:ARAMARK
Entity Type:Organization
Organization Name:ARAMARK
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OUTPATIENT DIETITIAN
Authorized Official - Prefix:MR
Authorized Official - First Name:CARMELO
Authorized Official - Middle Name:
Authorized Official - Last Name:RIVERA
Authorized Official - Suffix:JR
Authorized Official - Credentials:RD
Authorized Official - Phone:646-641-7427
Mailing Address - Street 1:1226 SHERMAN AVE
Mailing Address - Street 2:APT 21
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10456-3015
Mailing Address - Country:US
Mailing Address - Phone:646-641-7427
Mailing Address - Fax:
Practice Address - Street 1:1650 GRAND CONCOURSE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10457-7606
Practice Address - Country:US
Practice Address - Phone:646-641-7427
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-29
Last Update Date:2010-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006442261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center