Provider Demographics
NPI:1457169419
Name:JAM NUTRITION
Entity type:Organization
Organization Name:JAM NUTRITION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-FOUNDER, REGISTERED DIETITIAN
Authorized Official - Prefix:
Authorized Official - First Name:JULIA
Authorized Official - Middle Name:
Authorized Official - Last Name:PERLMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MS, RD, CDN
Authorized Official - Phone:914-200-8052
Mailing Address - Street 1:282 11TH AVE APT 1611
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10001-1268
Mailing Address - Country:US
Mailing Address - Phone:914-200-8052
Mailing Address - Fax:
Practice Address - Street 1:282 11TH AVE APT 1611
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10001-1268
Practice Address - Country:US
Practice Address - Phone:914-200-8052
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-23
Last Update Date:2025-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY5484964Medicaid
NY1952029845Medicaid