Provider Demographics
NPI:1033386958
Name:ROSENFELD, TAMRA B (MS, RDN, CDN)
Entity Type:Individual
Prefix:MRS
First Name:TAMRA
Middle Name:B
Last Name:ROSENFELD
Suffix:
Gender:F
Credentials:MS, RDN, CDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13 MIMOSA CIR
Mailing Address - Street 2:
Mailing Address - City:RIDGEFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06877-2502
Mailing Address - Country:US
Mailing Address - Phone:914-260-6216
Mailing Address - Fax:
Practice Address - Street 1:109 DANBURY RD STE D11
Practice Address - Street 2:
Practice Address - City:RIDGEFIELD
Practice Address - State:CT
Practice Address - Zip Code:06877-4142
Practice Address - Country:US
Practice Address - Phone:914-260-6216
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-09
Last Update Date:2019-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006605-1133V00000X
CT001421133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYA400006526Medicare PIN