Provider Demographics
NPI:1114218823
Name:OSEROFF, ELLEN
Entity Type:Individual
Prefix:MRS
First Name:ELLEN
Middle Name:
Last Name:OSEROFF
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 E 86TH ST
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10028-1062
Mailing Address - Country:US
Mailing Address - Phone:212-427-2000
Mailing Address - Fax:212-427-2008
Practice Address - Street 1:120 E 86TH ST
Practice Address - Street 2:2ND FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10028-1062
Practice Address - Country:US
Practice Address - Phone:212-427-2000
Practice Address - Fax:212-427-2008
Is Sole Proprietor?:No
Enumeration Date:2011-04-28
Last Update Date:2011-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered