Provider Demographics
NPI:1386268514
Name:GOLUB, CHELSEA (MS, RD)
Entity type:Individual
Prefix:
First Name:CHELSEA
Middle Name:
Last Name:GOLUB
Suffix:
Gender:F
Credentials:MS, RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:180 W 20TH ST APT PHF
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10011-3649
Mailing Address - Country:US
Mailing Address - Phone:862-377-5174
Mailing Address - Fax:
Practice Address - Street 1:180 W 20TH ST APT PHF
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10011-3649
Practice Address - Country:US
Practice Address - Phone:862-377-5174
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-03
Last Update Date:2020-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY85-1280213OtherIRS