Provider Demographics
NPI:1457419970
Name:CLARA CHEUNG NUTRITION CONSULTING, LLC
Entity type:Organization
Organization Name:CLARA CHEUNG NUTRITION CONSULTING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NUTRITIONIST
Authorized Official - Prefix:MS
Authorized Official - First Name:CLARA
Authorized Official - Middle Name:
Authorized Official - Last Name:CHEUNG
Authorized Official - Suffix:
Authorized Official - Credentials:RD
Authorized Official - Phone:212-966-3829
Mailing Address - Street 1:41 ELIZABETH ST
Mailing Address - Street 2:ROOM 501
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10013-4637
Mailing Address - Country:US
Mailing Address - Phone:212-966-3829
Mailing Address - Fax:212-966-2885
Practice Address - Street 1:41 ELIZABETH ST
Practice Address - Street 2:ROOM 501
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10013-4637
Practice Address - Country:US
Practice Address - Phone:212-966-3829
Practice Address - Fax:212-966-2885
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY4928429133N00000X
IL833435133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered133N00000XDietary & Nutritional Service ProvidersNutritionistGroup - Single Specialty
Not Answered133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WEY071Medicare ID - Type Unspecified
NYS02952Medicare UPIN