Provider Demographics
NPI:1245976182
Name:WILHELM, CHAYA (RDN)
Entity type:Individual
Prefix:
First Name:CHAYA
Middle Name:
Last Name:WILHELM
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 BALFOUR PL
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11225-4508
Mailing Address - Country:US
Mailing Address - Phone:347-268-3494
Mailing Address - Fax:
Practice Address - Street 1:200 PARK AVE STE 1700
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10166-0005
Practice Address - Country:US
Practice Address - Phone:347-265-1148
Practice Address - Fax:855-817-0064
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-12
Last Update Date:2022-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY010747133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered