Provider Demographics
NPI:1700936135
Name:PASTORE, CHER A (RD, CDE)
Entity Type:Individual
Prefix:
First Name:CHER
Middle Name:A
Last Name:PASTORE
Suffix:
Gender:F
Credentials:RD, CDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:155 E 34TH ST APT 5J
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-4756
Mailing Address - Country:US
Mailing Address - Phone:212-532-1305
Mailing Address - Fax:212-679-6160
Practice Address - Street 1:40 PARK AVE
Practice Address - Street 2:CAP NUTRITION, LLC
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-3467
Practice Address - Country:US
Practice Address - Phone:212-532-1305
Practice Address - Fax:212-679-6160
Is Sole Proprietor?:No
Enumeration Date:2007-01-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005593-1133VN1006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133VN1006XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Metabolic
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY2369233OtherUNITED
NY2951573002OtherCIGNA
NY7113496OtherAETNA
NY9533E1OtherBLUE CROSS BLUE SHIELD
NY184616POtherHIP
NYP2989242OtherOXFORD
NY5C8268OtherHEALTHNET
NYHIPOther00559348