Doctor Name: | LAURA CUSACK |
NPI Number: | 1083042394 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MS, RD |
License Number: | 1058541 |
Business Practice Address: | 245 Pak Ave. New York, NY - 10167 |
Business Phone Number: | 4755299139 |
Business Fax Number: | |
Mailing Address: | 245 Pak Ave., NEW YORK |
State: | NY |
Postal Code: | 10167 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 10/23/2013 |
NPI Last Update Date: | 01/24/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 133V00000X |
License Number: | 1058541 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CT |
Taxonomy Type: | Dietary & Nutritional Service Providers |
Taxonomy Classification: | Dietitian, Registered |
Taxonomy Specialization: | |
Taxonomy Definition: | A registered dietician (RD) is a food and nutrition expert who has successfully completed a minimum of a bachelor |