Provider Demographics
NPI:1841417284
Name:C&J CERTIFIED DIETITIAN NUTRITIONISTS PLLC
Entity Type:Organization
Organization Name:C&J CERTIFIED DIETITIAN NUTRITIONISTS PLLC
Other - Org Name:C&J NUTRITION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:WILLOW
Authorized Official - Middle Name:WREN
Authorized Official - Last Name:JAROSH
Authorized Official - Suffix:
Authorized Official - Credentials:MS, RD, CDN
Authorized Official - Phone:212-752-6770
Mailing Address - Street 1:515 MADISON AVE
Mailing Address - Street 2:SUITE 1906
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10022-5403
Mailing Address - Country:US
Mailing Address - Phone:212-752-6770
Mailing Address - Fax:212-754-0369
Practice Address - Street 1:515 MADISON AVE
Practice Address - Street 2:SUITE 1906
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10022-5403
Practice Address - Country:US
Practice Address - Phone:212-752-6770
Practice Address - Fax:212-754-0369
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty