Provider Demographics
NPI:1194500850
Name:TAILORED NUTRITION CONSULTANT SERVICES, PLLC
Entity type:Organization
Organization Name:TAILORED NUTRITION CONSULTANT SERVICES, PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SONYLMA
Authorized Official - Middle Name:
Authorized Official - Last Name:RAMOS
Authorized Official - Suffix:
Authorized Official - Credentials:RD,CDN,CDE
Authorized Official - Phone:718-658-6427
Mailing Address - Street 1:97 PURCELL ST
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10310-2730
Mailing Address - Country:US
Mailing Address - Phone:718-658-6427
Mailing Address - Fax:866-517-7517
Practice Address - Street 1:97 PURCELL ST
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10310-2730
Practice Address - Country:US
Practice Address - Phone:718-658-6427
Practice Address - Fax:866-517-7517
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-30
Last Update Date:2023-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Multi-Specialty