Provider Demographics
NPI:1013672377
Name:NUTRITION AND DIABETES HARMONY
Entity Type:Organization
Organization Name:NUTRITION AND DIABETES HARMONY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED DIETITIAN
Authorized Official - Prefix:
Authorized Official - First Name:MONICA
Authorized Official - Middle Name:
Authorized Official - Last Name:GONZALEZ
Authorized Official - Suffix:
Authorized Official - Credentials:RDN, CDN
Authorized Official - Phone:917-365-3386
Mailing Address - Street 1:2136 DEER PARK AVE # 14
Mailing Address - Street 2:
Mailing Address - City:DEER PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11729-1306
Mailing Address - Country:US
Mailing Address - Phone:917-365-3386
Mailing Address - Fax:855-919-6143
Practice Address - Street 1:2136 DEER PARK AVE # 14
Practice Address - Street 2:
Practice Address - City:DEER PARK
Practice Address - State:NY
Practice Address - Zip Code:11729-1306
Practice Address - Country:US
Practice Address - Phone:917-365-3386
Practice Address - Fax:855-919-6143
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-02
Last Update Date:2021-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty