Provider Demographics
NPI:1023638392
Name:COURTNEY DARSA NUTRITION LLC
Entity type:Organization
Organization Name:COURTNEY DARSA NUTRITION LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:RD
Authorized Official - Prefix:
Authorized Official - First Name:COURTNEY
Authorized Official - Middle Name:J
Authorized Official - Last Name:DARSA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-330-0944
Mailing Address - Street 1:16 MADISON SQ W FL 12
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10010-1629
Mailing Address - Country:US
Mailing Address - Phone:516-330-0944
Mailing Address - Fax:516-407-5377
Practice Address - Street 1:16 MADISON SQ W FL 12
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10010-1629
Practice Address - Country:US
Practice Address - Phone:516-330-0944
Practice Address - Fax:516-407-5377
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-16
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty