Individual provider Active NPI

Rusana Borochow, RD

  • Registered Dietitian
  • Fresh Meadows, NY
National Provider Identifier
1568690121
Registry record updated Jun 22, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
00979712 Issued in NY
Practice address
6933 170TH St
Fresh Meadows, NY 11365-3309
Phone
(718) 591-1610
NPI assigned
Jun 22, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 22, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 00979712 NY Primary

Addresses

Primary practice location

6933 170TH St
Fresh Meadows, NY 11365-3309

Mailing address

6933 170TH St
Fresh Meadows, NY 11365-3309
Phone (718) 591-1610

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

LicenseStateTypeSpecialty
00979712NYMDRegistered Dietitian
007062NYMDAcupuncturist

Networks

  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H3359

NPI Registry JSON

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

{
    "created_epoch": "1245628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1245628800000",
    "number": "1568690121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6933 170TH ST",
            "city": "FRESH MEADOWS",
            "state": "NY",
            "postal_code": "113653309",
            "telephone_number": "718-591-1610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6933 170TH ST",
            "city": "FRESH MEADOWS",
            "state": "NY",
            "postal_code": "113653309",
            "telephone_number": "718-591-1610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOROCHOW",
        "first_name": "RUSANA",
        "credential": "RD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-06-22",
        "last_updated": "2009-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NY",
            "license": "00979712",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresh Meadows, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2009; 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.