Provider Demographics
NPI:1811704679
Name:COMPLETE NUTRITION NY PLLC
Entity type:Organization
Organization Name:COMPLETE NUTRITION NY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ERICA
Authorized Official - Middle Name:
Authorized Official - Last Name:MITTELMAN SZANZER
Authorized Official - Suffix:
Authorized Official - Credentials:MS, RD, CDN, CDCES
Authorized Official - Phone:347-578-5112
Mailing Address - Street 1:1305 E 34TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11210-4819
Mailing Address - Country:US
Mailing Address - Phone:347-578-5112
Mailing Address - Fax:
Practice Address - Street 1:678 EASTERN PKWY
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11213-3311
Practice Address - Country:US
Practice Address - Phone:929-260-1661
Practice Address - Fax:888-711-3213
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-16
Last Update Date:2024-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Multi-Specialty