Provider Demographics
NPI:1457925315
Name:GROVER, NARDA (RD)
Entity Type:Individual
Prefix:
First Name:NARDA
Middle Name:
Last Name:GROVER
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:62 ROCKLEDGE RD APT 1A
Mailing Address - Street 2:
Mailing Address - City:HARTSDALE
Mailing Address - State:NY
Mailing Address - Zip Code:10530-3452
Mailing Address - Country:US
Mailing Address - Phone:914-275-5544
Mailing Address - Fax:888-822-2458
Practice Address - Street 1:62 ROCKLEDGE RD APT 1A
Practice Address - Street 2:
Practice Address - City:HARTSDALE
Practice Address - State:NY
Practice Address - Zip Code:10530-3452
Practice Address - Country:US
Practice Address - Phone:914-275-5544
Practice Address - Fax:888-822-2458
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-16
Last Update Date:2021-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY007469-01133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY007469-01OtherREGISTERED DIETITIEN