Provider Demographics
NPI:1396287041
Name:MEYERSON, REBECCA (MS)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:
Last Name:MEYERSON
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 GURNEE AVE
Mailing Address - Street 2:
Mailing Address - City:NYACK
Mailing Address - State:NY
Mailing Address - Zip Code:10960-4706
Mailing Address - Country:US
Mailing Address - Phone:914-806-5938
Mailing Address - Fax:
Practice Address - Street 1:2 GURNEE AVE
Practice Address - Street 2:
Practice Address - City:NYACK
Practice Address - State:NY
Practice Address - Zip Code:10960-4706
Practice Address - Country:US
Practice Address - Phone:914-806-5938
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-12
Last Update Date:2016-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist