Provider Demographics
NPI:1538640925
Name:PAPPA, ABRA (CNS - NUTRITIONIST)
Entity Type:Individual
Prefix:
First Name:ABRA
Middle Name:
Last Name:PAPPA
Suffix:
Gender:F
Credentials:CNS - NUTRITIONIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:929 W END AVE APT 4B
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10025-3550
Mailing Address - Country:US
Mailing Address - Phone:646-303-5404
Mailing Address - Fax:
Practice Address - Street 1:929 W END AVE APT 4B
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10025-3550
Practice Address - Country:US
Practice Address - Phone:646-303-5404
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-24
Last Update Date:2021-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYCNS-17558133N00000X
PADN007178133N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist