Basic Information
| Provider Information | |||||||||
| NPI: | 1528410818 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SCHELLER | ||||||||
| FirstName: | BROOKE | ||||||||
| MiddleName: | LEIGH | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | DCN, CNS | ||||||||
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| Mailing Information | |||||||||
| Address1: | 137 RIVINGTON ST APT A | ||||||||
| Address2: | |||||||||
| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 100022486 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7327731534 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 274 MADISON AVE RM 1501 | ||||||||
| Address2: | |||||||||
| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 100160701 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2122031773 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/11/2016 | ||||||||
| LastUpdateDate: | 07/22/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 07/22/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 133NN1002X | N | Dietary & Nutritional Service Providers | Nutritionist | Nutrition, Education | 133N00000X | Y | Dietary & Nutritional Service Providers | Nutritionist |
No ID Information.