Provider Demographics
NPI:1700473592
Name:URBAN NUTRITION CONSULTANTS, LLC
Entity Type:Organization
Organization Name:URBAN NUTRITION CONSULTANTS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:NICHOLAS
Authorized Official - Middle Name:E
Authorized Official - Last Name:RUSH
Authorized Official - Suffix:
Authorized Official - Credentials:RDN, CDN
Authorized Official - Phone:901-238-8466
Mailing Address - Street 1:65 W 106TH ST APT 3D
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10025-3835
Mailing Address - Country:US
Mailing Address - Phone:901-238-8466
Mailing Address - Fax:833-734-1635
Practice Address - Street 1:65 W 106TH ST APT 3D
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10025-3835
Practice Address - Country:US
Practice Address - Phone:901-238-8466
Practice Address - Fax:833-734-1635
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-28
Last Update Date:2020-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Multi-Specialty