Active NPI
Ilana Beth Bronheim, MS, RD, CDN
- Registered Dietitian
- Bronx, NY
National Provider Identifier
1093079246
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 1027329
- Practice address
- 1621 Eastchester Rd
Bronx, NY 10461-2604 - Phone
- (718) 405-8352
- NPI assigned
- Jul 2, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 1027329 | NY | Primary |
Addresses
Primary practice location
1621 Eastchester Rd
Bronx, NY 10461-2604
Mailing address
1621 Eastchester Rd
Bronx, NY 10461-2604
Phone (718) 405-8352
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1027329 | NY | MD | Registered Dietitian |
| 007117 | NY | MD | Acupuncturist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1341187200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1398816000000",
"number": "1093079246",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1621 EASTCHESTER RD",
"city": "BRONX",
"state": "NY",
"postal_code": "104612604",
"telephone_number": "718-405-8352"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1621 EASTCHESTER RD",
"city": "BRONX",
"state": "NY",
"postal_code": "104612604",
"telephone_number": "718-405-8352"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRONHEIM",
"first_name": "ILANA",
"middle_name": "BETH",
"credential": "MS, RD, CDN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-07-02",
"last_updated": "2014-04-30",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "NY",
"license": "1027329",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bronx, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.