Provider Demographics
NPI:1114100732
Name:TANSMAN, LAURIE SUE (MS, RD, CDN)
Entity Type:Individual
Prefix:MISS
First Name:LAURIE
Middle Name:SUE
Last Name:TANSMAN
Suffix:
Gender:F
Credentials:MS, RD, CDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:446 E 86TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10028-6466
Mailing Address - Country:US
Mailing Address - Phone:212-570-9084
Mailing Address - Fax:212-849-2588
Practice Address - Street 1:446 E 86TH ST
Practice Address - Street 2:APT 5G
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10028-6466
Practice Address - Country:US
Practice Address - Phone:212-570-9084
Practice Address - Fax:212-849-2588
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-06
Last Update Date:2007-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY003432133V00000X
707082133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
707082OtherCDR
NY003432OtherNYS EDUCATION DEPT