Provider Demographics
NPI:1568236008
Name:DANNENBAUM, MARLEE JULES (RD)
Entity Type:Individual
Prefix:
First Name:MARLEE
Middle Name:JULES
Last Name:DANNENBAUM
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 1:401 2ND AVE APT 11E
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10010-3913
Mailing Address - Country:US
Mailing Address - Phone:609-472-9539
Mailing Address - Fax:
Practice Address - Street 1:401 2ND AVE APT 11E
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10010-3913
Practice Address - Country:US
Practice Address - Phone:609-472-9539
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-14
Last Update Date:2023-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered