Provider Demographics
NPI:1558691147
Name:PLATZMAN, ANDREA (RD)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:
Last Name:PLATZMAN
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1520 YORK AVE
Mailing Address - Street 2:APT. 17A
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10028-7008
Mailing Address - Country:US
Mailing Address - Phone:212-249-0944
Mailing Address - Fax:212-327-0857
Practice Address - Street 1:1520 YORK AVE
Practice Address - Street 2:APT. 17A
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10028-7008
Practice Address - Country:US
Practice Address - Phone:212-249-0944
Practice Address - Fax:212-327-0857
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-05
Last Update Date:2010-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY001977-1133V00000X
PADN004152133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered