Wilda Souffrant, RDN

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

1035358 Issued in NY

Practice address

327 Beach 19TH St
Far Rockaway, NY 11691-4423

Phone

(718) 869-7000

NPI assigned

Aug 8, 2017

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1502150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1922523273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 NORFELD BLVD",
            "city": "ELMONT",
            "state": "NY",
            "postal_code": "110033639",
            "telephone_number": "718-664-8798"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "327 BEACH 19TH ST",
            "city": "FAR ROCKAWAY",
            "state": "NY",
            "postal_code": "116914423",
            "telephone_number": "718-869-7000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "112 Norfeld Blvd",
            "address_purpose": "LOCATION",
            "city": "Elmont",
            "state": "NY",
            "postal_code": "110033639",
            "country_code": "US",
            "telephone_number": "718-664-8798",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SOUFFRANT",
        "first_name": "WILDA",
        "credential": "RDN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-08-08",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NY",
            "license": "1035358",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ariella Somerstein, OTR/L
• Phyo Sone
• Sonia Roney LLC
• Laura Mary Sophocleous, LCSW, LMFT, CASAC
• Mostafa Karam Sorour Mahmoud
• South Beach Medical PC
• South Beach OB GYN
• South Island Medical Associates PC
• South Shore Thoracic & Cardiovascular Surgical Group PC
• Olusola Esther Sowemimo, MBA

• Registered Dietitian in Far Rockaway, NY
• Providers in Far Rockaway, NY by specialty
• Registered Dietitian in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.