Provider Demographics
NPI:1801820485
Name:ROCKMAN-KLEIN, SUZANNE H (RD,CDN)
Entity type:Individual
Prefix:
First Name:SUZANNE
Middle Name:H
Last Name:ROCKMAN-KLEIN
Suffix:
Gender:F
Credentials:RD,CDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 NEVA CT
Mailing Address - Street 2:
Mailing Address - City:SUFFERN
Mailing Address - State:NY
Mailing Address - Zip Code:10901-3329
Mailing Address - Country:US
Mailing Address - Phone:914-523-4591
Mailing Address - Fax:845-362-1338
Practice Address - Street 1:3 NEVA CT
Practice Address - Street 2:
Practice Address - City:SUFFERN
Practice Address - State:NY
Practice Address - Zip Code:10901-3329
Practice Address - Country:US
Practice Address - Phone:914-523-4591
Practice Address - Fax:845-362-1338
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2011-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000758133N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01421705Medicaid
NYD3P281Medicare ID - Type Unspecified