Provider Demographics
NPI:1922987270
Name:BLACK, MEREDITH MCLENDON (RDN, IBCLC)
Entity type:Individual
Prefix:MS
First Name:MEREDITH
Middle Name:MCLENDON
Last Name:BLACK
Suffix:
Gender:F
Credentials:RDN, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:444 E 78TH ST APT A
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10075-1671
Mailing Address - Country:US
Mailing Address - Phone:864-230-9975
Mailing Address - Fax:
Practice Address - Street 1:444 E 78TH ST APT A
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10075-1671
Practice Address - Country:US
Practice Address - Phone:864-230-9975
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-30
Last Update Date:2025-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY008787133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered