Provider Demographics
NPI:1104424100
Name:DMC NUTRITION LLC
Entity type:Organization
Organization Name:DMC NUTRITION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT, OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:
Authorized Official - Last Name:MALKOFF-COHEN
Authorized Official - Suffix:
Authorized Official - Credentials:MS, RD, CDN
Authorized Official - Phone:516-728-6261
Mailing Address - Street 1:425 E 72ND ST APT 2G
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021-4422
Mailing Address - Country:US
Mailing Address - Phone:516-728-6261
Mailing Address - Fax:888-314-6681
Practice Address - Street 1:215 E 68TH ST OFC 8
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10065-5718
Practice Address - Country:US
Practice Address - Phone:516-728-6261
Practice Address - Fax:888-314-6681
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-12
Last Update Date:2020-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty