Provider Demographics
NPI:1588012249
Name:FOODIE FARMACIST LLC
Entity Type:Organization
Organization Name:FOODIE FARMACIST LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NUTRITIONIST
Authorized Official - Prefix:MS
Authorized Official - First Name:LARA
Authorized Official - Middle Name:
Authorized Official - Last Name:ZAKARIA
Authorized Official - Suffix:
Authorized Official - Credentials:BSPHARM MS RPH
Authorized Official - Phone:929-354-3236
Mailing Address - Street 1:611 W 163RD ST
Mailing Address - Street 2:SUITE 24
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10032-5628
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:611 W 163RD ST
Practice Address - Street 2:SUITE 24
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10032-5628
Practice Address - Country:US
Practice Address - Phone:929-354-3236
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-02
Last Update Date:2016-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133N00000XDietary & Nutritional Service ProvidersNutritionistGroup - Single Specialty