Provider Demographics
NPI:1750884516
Name:SROSS NUTRITION PLLC
Entity type:Organization
Organization Name:SROSS NUTRITION PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:THE FOUNDER AND CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:SILVIA
Authorized Official - Middle Name:CAROLINA
Authorized Official - Last Name:ROSS
Authorized Official - Suffix:
Authorized Official - Credentials:MS,RDN, CDN
Authorized Official - Phone:561-843-5083
Mailing Address - Street 1:131 ORCHARD RD
Mailing Address - Street 2:
Mailing Address - City:BRIARCLIFF MANOR
Mailing Address - State:NY
Mailing Address - Zip Code:10510-1026
Mailing Address - Country:US
Mailing Address - Phone:561-843-5083
Mailing Address - Fax:914-924-4841
Practice Address - Street 1:131 ORCHARD RD
Practice Address - Street 2:
Practice Address - City:BRIARCLIFF MANOR
Practice Address - State:NY
Practice Address - Zip Code:10510-1026
Practice Address - Country:US
Practice Address - Phone:561-843-5083
Practice Address - Fax:914-924-4841
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-16
Last Update Date:2018-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY008982-1133V00000X
86020094133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty