Provider Demographics
NPI:1942900089
Name:YELLIN, REBECCA (RD, CDN, CDCES)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:
Last Name:YELLIN
Suffix:
Gender:F
Credentials:RD, CDN, CDCES
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:131 LINCOLN RD APT 1J
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11225-4021
Mailing Address - Country:US
Mailing Address - Phone:973-508-8041
Mailing Address - Fax:
Practice Address - Street 1:678 LINCOLN PL APT 2F
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11216-4402
Practice Address - Country:US
Practice Address - Phone:973-508-8041
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-07
Last Update Date:2024-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered