Provider Demographics
NPI:1821299504
Name:CAP NUTRITION, LLC
Entity Type:Organization
Organization Name:CAP NUTRITION, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:CHER
Authorized Official - Middle Name:A
Authorized Official - Last Name:PASTORE
Authorized Official - Suffix:
Authorized Official - Credentials:MS RD CDE
Authorized Official - Phone:212-532-1305
Mailing Address - Street 1:40 PARK AVE
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-3467
Mailing Address - Country:US
Mailing Address - Phone:212-532-1305
Mailing Address - Fax:212-679-6160
Practice Address - Street 1:40 PARK AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-3467
Practice Address - Country:US
Practice Address - Phone:212-532-1305
Practice Address - Fax:212-679-6160
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005593133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY184616POtherHIP PROVIDER #
NYP2989242OtherOXFORD
NY00559348OtherLICENSE NUMBER
NY7113496OtherAETNA