Provider Demographics
NPI:1477355816
Name:BLUMBERG, RACHEL (RD, CDN)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:
Last Name:BLUMBERG
Suffix:
Gender:
Credentials:RD, CDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34 YALE AVE
Mailing Address - Street 2:
Mailing Address - City:HEWLETT
Mailing Address - State:NY
Mailing Address - Zip Code:11557-1528
Mailing Address - Country:US
Mailing Address - Phone:347-233-1844
Mailing Address - Fax:
Practice Address - Street 1:1111 MARCUS AVE STE M15
Practice Address - Street 2:
Practice Address - City:NEW HYDE PARK
Practice Address - State:NY
Practice Address - Zip Code:11042-1034
Practice Address - Country:US
Practice Address - Phone:516-601-7200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-26
Last Update Date:2025-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered