Provider Demographics
NPI:1275785933
Name:PATH FOR LIFE INC.
Entity Type:Organization
Organization Name:PATH FOR LIFE INC.
Other - Org Name:PATH FOR LIFE SELF-NOURISHMENT CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:NOURISHMENT COUNSELOR
Authorized Official - Prefix:MS
Authorized Official - First Name:JEANETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:BRONEE
Authorized Official - Suffix:
Authorized Official - Credentials:HHC, AADP
Authorized Official - Phone:212-260-0604
Mailing Address - Street 1:80 E 11TH ST
Mailing Address - Street 2:SUITE 623
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10003-6811
Mailing Address - Country:US
Mailing Address - Phone:212-260-0604
Mailing Address - Fax:
Practice Address - Street 1:80 E 11TH ST
Practice Address - Street 2:SUITE 623
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003-6811
Practice Address - Country:US
Practice Address - Phone:212-260-0604
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-14
Last Update Date:2008-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY80302406133NN1002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, EducationGroup - Multi-Specialty