Provider Demographics
NPI:1639670391
Name:BELFER-LEHAT, IRINA (RDN)
Entity type:Individual
Prefix:
First Name:IRINA
Middle Name:
Last Name:BELFER-LEHAT
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 1:127 FAIRVIEW AVE
Mailing Address - Street 2:
Mailing Address - City:GREAT NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11023-1330
Mailing Address - Country:US
Mailing Address - Phone:917-769-8031
Mailing Address - Fax:
Practice Address - Street 1:127 FAIRVIEW AVE
Practice Address - Street 2:
Practice Address - City:GREAT NECK
Practice Address - State:NY
Practice Address - Zip Code:11023-1330
Practice Address - Country:US
Practice Address - Phone:917-769-8031
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-27
Last Update Date:2022-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005639133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty