Provider Demographics
NPI:1518797703
Name:HOLNESS FOODS LLC
Entity type:Organization
Organization Name:HOLNESS FOODS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED DIETITIAN NUTRITIONIST
Authorized Official - Prefix:
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:
Authorized Official - Last Name:HOLNESS
Authorized Official - Suffix:
Authorized Official - Credentials:MS, RD, CDN, IBCLC
Authorized Official - Phone:212-484-9789
Mailing Address - Street 1:99 WALL ST STE 899
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10005-4301
Mailing Address - Country:US
Mailing Address - Phone:212-484-9789
Mailing Address - Fax:
Practice Address - Street 1:3420 AVENUE H APT 2A
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11210-3335
Practice Address - Country:US
Practice Address - Phone:212-484-9789
Practice Address - Fax:332-287-9978
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HOLNESS FOODS LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-08-03
Last Update Date:2024-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Multi-Specialty