Active NPI
Avital Greenbaum, R.D., C.D.N
- Registered Dietitian
- Forest Hills, NY
National Provider Identifier
1700153616
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 007133
- Practice address
- 10225 67TH Dr
Apt 1G
Forest Hills, NY 11375-2860 - Phone
- (201) 403-4125
- NPI assigned
- Nov 20, 2011
- Sex
- Female
- Sole proprietor
- Yes
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 | 007133 | NY | Primary |
Addresses
Primary practice location
10225 67TH Dr
Apt 1G
Forest Hills, NY 11375-2860
Mailing address
10225 67TH Dr
Apt 1G
Forest Hills, NY 11375-2860
Phone (201) 403-4125
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 007133 | NY | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1321747200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1321747200000",
"number": "1700153616",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10225 67TH DR",
"address_2": "APT 1G",
"city": "FOREST HILLS",
"state": "NY",
"postal_code": "113752860",
"telephone_number": "201-403-4125"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10225 67TH DR",
"address_2": "APT 1G",
"city": "FOREST HILLS",
"state": "NY",
"postal_code": "113752860",
"telephone_number": "201-403-4125"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GREENBAUM",
"first_name": "AVITAL",
"name_prefix": "Mrs.",
"credential": "R.D., C.D.N",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-11-20",
"last_updated": "2011-11-20",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "NY",
"license": "007133",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Forest Hills, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.