Allergy Nutritionist LLC

Primary specialty

Registered DietitianTaxonomy code 133V00000X

Legal business name

ALLERGY NUTRITIONIST LLC

Practice address

428 Prospect St
South Orange, NJ 07079-1832

Phone

(917) 399-0548

NPI assigned

Feb 19, 2024

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ilana Dubrovsky-Razam, RDNNPI 1841974300

Title

Owner

Phone

(917) 399-0548

Specialties & licenses 1

Addresses

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Ilana Dubrovsky-Razam, RDN

  • Registered Dietitian
  • South Orange, NJ
  • NPI 1841974300

  Dietitian, Registered

  NPD Authorized official
• Julie Campbell, REGISTERED DIETITIAN

  • Registered Dietitian
  • Midland Park, NJ
  • NPI 1477392454

  Dietitian, Registered

  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1708300800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1708300800000",
    "number": "1073378006",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "428 PROSPECT ST",
            "city": "SOUTH ORANGE",
            "state": "NJ",
            "postal_code": "070791832"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "428 PROSPECT ST",
            "city": "SOUTH ORANGE",
            "state": "NJ",
            "postal_code": "070791832",
            "telephone_number": "917-399-0548"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALLERGY NUTRITIONIST LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-02-19",
        "last_updated": "2024-02-19",
        "certification_date": "2024-02-19",
        "status": "A",
        "authorized_official_last_name": "DUBROVSKY-RAZAM",
        "authorized_official_first_name": "ILANA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "917-399-0548",
        "authorized_official_credential": "RDN"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Registered Dietitian in South Orange, NJ
• Providers in South Orange, NJ by specialty
• Registered Dietitian in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.