Provider Demographics
NPI:1235741158
Name:RUBELLO, PAULA YVETTE (RDN)
Entity Type:Individual
Prefix:
First Name:PAULA
Middle Name:YVETTE
Last Name:RUBELLO
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:288 LEXINGTON AVE APT 1H
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-3543
Mailing Address - Country:US
Mailing Address - Phone:267-772-7982
Mailing Address - Fax:
Practice Address - Street 1:1551 E 4TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11230-6318
Practice Address - Country:US
Practice Address - Phone:347-292-1725
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-21
Last Update Date:2020-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered