Basic Information
| Provider Information | |||||||||
| NPI: | 1306356274 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | IRIS EPSTEIN & ASSOCIATES LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 978 ROUTE 45 STE 107 | ||||||||
| Address2: | |||||||||
| City: | POMONA | ||||||||
| State: | NY | ||||||||
| PostalCode: | 109703512 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8453628400 | ||||||||
| FaxNumber: | 8453621308 | ||||||||
| Practice Location | |||||||||
| Address1: | 978 ROUTE 45 STE 107 | ||||||||
| Address2: | |||||||||
| City: | POMONA | ||||||||
| State: | NY | ||||||||
| PostalCode: | 109703512 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8453628400 | ||||||||
| FaxNumber: | 8453621308 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/05/2017 | ||||||||
| LastUpdateDate: | 10/05/2017 | ||||||||
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| AuthorizedOfficialLastName: | EPSTEIN | ||||||||
| AuthorizedOfficialFirstName: | IRIS | ||||||||
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| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 8453621300 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | RD CDE CEDRD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 133V00000X | 003101-1 | NY | Y | 193400000X SINGLE SPECIALTY GROUP | Dietary & Nutritional Service Providers | Dietitian, Registered |
No ID Information.