Provider Demographics
NPI:1710394366
Name:HUDSON VALLEY NUTRITION PLLC.
Entity Type:Organization
Organization Name:HUDSON VALLEY NUTRITION PLLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED DIETITIAN
Authorized Official - Prefix:MS
Authorized Official - First Name:DAWN
Authorized Official - Middle Name:LOUISE
Authorized Official - Last Name:COFFEY
Authorized Official - Suffix:
Authorized Official - Credentials:RD
Authorized Official - Phone:845-641-8773
Mailing Address - Street 1:21 EBERLING DR
Mailing Address - Street 2:NEW CITY, NEW YORK
Mailing Address - City:NEW CITY
Mailing Address - State:NY
Mailing Address - Zip Code:10956-3703
Mailing Address - Country:US
Mailing Address - Phone:845-641-8773
Mailing Address - Fax:
Practice Address - Street 1:21 EBERLING DR
Practice Address - Street 2:NEW CITY, NEW YORK
Practice Address - City:NEW CITY
Practice Address - State:NY
Practice Address - Zip Code:10956-3703
Practice Address - Country:US
Practice Address - Phone:845-641-8773
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-16
Last Update Date:2015-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY007017-1133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty