Active NPI
Elisa Munroe
- Nutritionist
- Bronx, NY
National Provider Identifier
1235202714
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nutritionist
- License
- 929431
- Practice address
- 1065 Southern Blvd
Bronx, NY 10459-2417 - Phone
- (718) 589-2440
- NPI assigned
- Nov 15, 2006
- 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 |
|---|---|---|---|---|
| Nutritionist | 133N00000X | 929431 | NY | Primary |
Addresses
Primary practice location
1065 Southern Blvd
Bronx, NY 10459-2417
Mailing address
1065 Southern Blvd
Bronx, NY 10459-2417
Phone (718) 589-2440
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 929431 | NY | MD | Nutritionist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fay Nutrition | Past | Accepting new patients | |
| Queens Medical Office, P.C. | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Internal Medicine Physician
- Elmhurst, NY
- NPI 1922017789
-
- Registered Dietitian
- San Francisco, CA
- NPI 1104334465
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163548800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1187913600000",
"number": "1235202714",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1065 SOUTHERN BLVD",
"city": "BRONX",
"state": "NY",
"postal_code": "104592417",
"telephone_number": "718-589-2440"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1065 SOUTHERN BLVD",
"city": "BRONX",
"state": "NY",
"postal_code": "104592417",
"telephone_number": "718-589-2440"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MUNROE",
"first_name": "ELISA",
"name_prefix": "Ms.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-11-15",
"last_updated": "2007-08-24",
"status": "A"
},
"taxonomies": [
{
"code": "133N00000X",
"taxonomy_group": "",
"desc": "Nutritionist",
"state": "NY",
"license": "929431",
"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 Aug 24, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.