Provider Demographics
NPI:1942752415
Name:MARY OPFER NUTRITION PLLC
Entity Type:Organization
Organization Name:MARY OPFER NUTRITION PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:
Authorized Official - Last Name:OPFER
Authorized Official - Suffix:
Authorized Official - Credentials:MS, RD
Authorized Official - Phone:914-774-8530
Mailing Address - Street 1:378 ROUTE 202
Mailing Address - Street 2:
Mailing Address - City:SOMERS
Mailing Address - State:NY
Mailing Address - Zip Code:10589-3248
Mailing Address - Country:US
Mailing Address - Phone:914-617-8585
Mailing Address - Fax:
Practice Address - Street 1:378 ROUTE 202
Practice Address - Street 2:
Practice Address - City:SOMERS
Practice Address - State:NY
Practice Address - Zip Code:10589-3248
Practice Address - Country:US
Practice Address - Phone:914-617-8585
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-31
Last Update Date:2016-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty