Provider Demographics
NPI:1609248517
Name:LEAH KAUFMAN NUTRITION LLC
Entity Type:Organization
Organization Name:LEAH KAUFMAN NUTRITION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:LEAH
Authorized Official - Middle Name:
Authorized Official - Last Name:KAUFMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MS, RD, CDN
Authorized Official - Phone:732-996-0066
Mailing Address - Street 1:235 W 22ND ST APT 5Y
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10011-2746
Mailing Address - Country:US
Mailing Address - Phone:732-996-0066
Mailing Address - Fax:
Practice Address - Street 1:149 MADISON AVE
Practice Address - Street 2:SUITE 1135
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-6713
Practice Address - Country:US
Practice Address - Phone:732-996-0066
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-30
Last Update Date:2015-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty