Provider Demographics
NPI:1346415189
Name:FOOD AND NUTRITION CONNECTION, PLLC
Entity Type:Organization
Organization Name:FOOD AND NUTRITION CONNECTION, PLLC
Other - Org Name:EATFOOD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:
Authorized Official - Last Name:FASSBERG
Authorized Official - Suffix:
Authorized Official - Credentials:MS,RD
Authorized Official - Phone:212-980-4127
Mailing Address - Street 1:242 E 60TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10022-1453
Mailing Address - Country:US
Mailing Address - Phone:212-980-4127
Mailing Address - Fax:212-980-9828
Practice Address - Street 1:242 E 60TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10022-1453
Practice Address - Country:US
Practice Address - Phone:212-980-4127
Practice Address - Fax:212-980-9828
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-23
Last Update Date:2009-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY5587133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYP3557364OtherOXFORD