Provider Demographics
NPI:1043810724
Name:KEATS NUTRITION
Entity Type:Organization
Organization Name:KEATS NUTRITION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:SHARI
Authorized Official - Middle Name:
Authorized Official - Last Name:KEATS
Authorized Official - Suffix:
Authorized Official - Credentials:MS, RDN, CDN
Authorized Official - Phone:914-806-7151
Mailing Address - Street 1:6 THORNWOOD PL
Mailing Address - Street 2:
Mailing Address - City:SCARSDALE
Mailing Address - State:NY
Mailing Address - Zip Code:10583-7428
Mailing Address - Country:US
Mailing Address - Phone:914-806-7151
Mailing Address - Fax:
Practice Address - Street 1:6 THORNWOOD PL
Practice Address - Street 2:
Practice Address - City:SCARSDALE
Practice Address - State:NY
Practice Address - Zip Code:10583-7428
Practice Address - Country:US
Practice Address - Phone:914-806-7151
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-30
Last Update Date:2020-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty