Provider Demographics
NPI:1124578489
Name:COHEN, WINTER (RD)
Entity Type:Individual
Prefix:
First Name:WINTER
Middle Name:
Last Name:COHEN
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:135 W 79TH ST
Mailing Address - Street 2:APT 10B
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10024-6403
Mailing Address - Country:US
Mailing Address - Phone:347-860-5590
Mailing Address - Fax:
Practice Address - Street 1:135 W 79TH ST
Practice Address - Street 2:APT 10B
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10024-6403
Practice Address - Country:US
Practice Address - Phone:347-860-5590
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-11
Last Update Date:2016-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY008691133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered