Provider Demographics
NPI:1487249876
Name:YOUR FOOD NUTRITION COACH, LLC
Entity type:Organization
Organization Name:YOUR FOOD NUTRITION COACH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DEANA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:RODRIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:RDN
Authorized Official - Phone:201-614-1900
Mailing Address - Street 1:688 SEAGULL DRIVE
Mailing Address - Street 2:
Mailing Address - City:PARAMUS
Mailing Address - State:NJ
Mailing Address - Zip Code:07652-4944
Mailing Address - Country:US
Mailing Address - Phone:201-960-9636
Mailing Address - Fax:201-881-1629
Practice Address - Street 1:140 E RIDGEWOOD AVE STE 415
Practice Address - Street 2:
Practice Address - City:PARAMUS
Practice Address - State:NJ
Practice Address - Zip Code:07652-3915
Practice Address - Country:US
Practice Address - Phone:201-720-1900
Practice Address - Fax:201-367-3779
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-08
Last Update Date:2024-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Multi-Specialty
No133VN1101XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, GerontologicalGroup - Multi-Specialty
No133VN1201XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Obesity and Weight ManagementGroup - Multi-Specialty