Provider Demographics
NPI:1306394895
Name:RAFELD, MICHELE (MS, RD)
Entity Type:Individual
Prefix:MRS
First Name:MICHELE
Middle Name:
Last Name:RAFELD
Suffix:
Gender:F
Credentials:MS, RD
Other - Prefix:MS
Other - First Name:MICHELE
Other - Middle Name:
Other - Last Name:ANGEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, RD
Mailing Address - Street 1:315 E 21ST ST
Mailing Address - Street 2:APT. 2L
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10010-6554
Mailing Address - Country:US
Mailing Address - Phone:914-843-2716
Mailing Address - Fax:
Practice Address - Street 1:315 EAST 21ST ST
Practice Address - Street 2:APT. 2L
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10010
Practice Address - Country:US
Practice Address - Phone:914-843-2716
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-14
Last Update Date:2016-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY86051862133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered