Provider Demographics
NPI:1508436874
Name:DOEBRICH, PAULA (MPH, RDN)
Entity Type:Individual
Prefix:
First Name:PAULA
Middle Name:
Last Name:DOEBRICH
Suffix:
Gender:F
Credentials:MPH, RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:43 CHARLES ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10014-2895
Mailing Address - Country:US
Mailing Address - Phone:424-386-5421
Mailing Address - Fax:
Practice Address - Street 1:43 CHARLES ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10014-2895
Practice Address - Country:US
Practice Address - Phone:424-386-5421
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-29
Last Update Date:2022-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY86155742133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered