Provider Demographics
NPI:1801392105
Name:RUEVEN, SARAH MIRIAM (RDN, CDN)
Entity Type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:MIRIAM
Last Name:RUEVEN
Suffix:
Gender:F
Credentials:RDN, CDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:250 WEST ST APT 9JK
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10013-7507
Mailing Address - Country:US
Mailing Address - Phone:240-888-7772
Mailing Address - Fax:
Practice Address - Street 1:40 WORTH ST STE 1063
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10013-2904
Practice Address - Country:US
Practice Address - Phone:240-888-7772
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-04
Last Update Date:2018-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY008527133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
86019797OtherREGISTERED DIETITIAN NUTRITIONIST
NY008527OtherCERTIFIED DIETITIAN NUTRITIONIST