Provider Demographics
NPI:1932794161
Name:LAURA IU NUTRITION LLC
Entity Type:Organization
Organization Name:LAURA IU NUTRITION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED DIETITIAN NUTRITIONIST
Authorized Official - Prefix:
Authorized Official - First Name:KIN WAH
Authorized Official - Middle Name:LAURA
Authorized Official - Last Name:IU
Authorized Official - Suffix:
Authorized Official - Credentials:RD, CDN, CNSC, RYT
Authorized Official - Phone:212-400-7126
Mailing Address - Street 1:33 W 19TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10011-4333
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:33 W 19TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10011-4333
Practice Address - Country:US
Practice Address - Phone:212-400-7126
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-09
Last Update Date:2021-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Multi-Specialty