Provider Demographics
NPI:1083151872
Name:VVF DIETITIAN-NUTRITIONIST PC
Entity Type:Organization
Organization Name:VVF DIETITIAN-NUTRITIONIST PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:VICTORYA
Authorized Official - Middle Name:
Authorized Official - Last Name:FOGEL
Authorized Official - Suffix:
Authorized Official - Credentials:RD
Authorized Official - Phone:718-975-8500
Mailing Address - Street 1:444 NEPTUNE AVE
Mailing Address - Street 2:STE 8J
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11224-4456
Mailing Address - Country:US
Mailing Address - Phone:718-975-8500
Mailing Address - Fax:718-975-8502
Practice Address - Street 1:1009 BRIGHTON BEACH AVE
Practice Address - Street 2:2ND FL
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11235-5659
Practice Address - Country:US
Practice Address - Phone:718-975-8500
Practice Address - Fax:718-975-8502
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-31
Last Update Date:2017-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty