Provider Demographics
NPI:1407280548
Name:SARONSON, ROBERT LORIN (LAC, RD)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:LORIN
Last Name:SARONSON
Suffix:
Gender:M
Credentials:LAC, RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2322 E 18TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11229-4417
Mailing Address - Country:US
Mailing Address - Phone:917-378-8585
Mailing Address - Fax:
Practice Address - Street 1:2322 E 18TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11229-4417
Practice Address - Country:US
Practice Address - Phone:917-378-8585
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-26
Last Update Date:2019-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY958192133V00000X
NY25005137171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
No133V00000XDietary & Nutritional Service ProvidersDietitian, Registered