Provider Demographics
NPI:1760005748
Name:HORMATI, JASMINE (MS, RDN)
Entity Type:Individual
Prefix:
First Name:JASMINE
Middle Name:
Last Name:HORMATI
Suffix:
Gender:F
Credentials:MS, RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:405 EDGECOMBE AVE APT E4
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10032-8019
Mailing Address - Country:US
Mailing Address - Phone:310-897-6097
Mailing Address - Fax:
Practice Address - Street 1:405 EDGECOMBE AVE #E4
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10032
Practice Address - Country:US
Practice Address - Phone:917-719-0019
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-25
Last Update Date:2022-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered