Provider Demographics
NPI:1467898981
Name:RIFKIN, MELISSA RENE (MS, RD CDN)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:RENE
Last Name:RIFKIN
Suffix:
Gender:F
Credentials:MS, RD CDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:408 E 92ND ST
Mailing Address - Street 2:APT 22D
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10128-6811
Mailing Address - Country:US
Mailing Address - Phone:603-860-2625
Mailing Address - Fax:845-794-0716
Practice Address - Street 1:408 E 92ND ST
Practice Address - Street 2:APT 22D
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10128-6811
Practice Address - Country:US
Practice Address - Phone:603-860-2625
Practice Address - Fax:845-794-0716
Is Sole Proprietor?:No
Enumeration Date:2013-05-13
Last Update Date:2013-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006224-1133N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist