Basic Information
Provider Information | |||||||||
NPI: | 1487016614 | ||||||||
EntityType: | 1 | ||||||||
ReplacementNPI: |   | ||||||||
OrganizationName: |   | ||||||||
LastName: | FEIT | ||||||||
FirstName: | JAMIE | ||||||||
MiddleName: | MEREDITH | ||||||||
NamePrefix: |   | ||||||||
NameSuffix: |   | ||||||||
Credential: | MS, RD | ||||||||
OtherOrganizationName: |   | ||||||||
OtherOrganizationType: |   | ||||||||
OtherLastName: |   | ||||||||
OtherFirstName: |   | ||||||||
OtherMiddleName: |   | ||||||||
OtherNamePrefix: |   | ||||||||
OtherNameSuffix: |   | ||||||||
OtherCredential: |   | ||||||||
OtherLastNameType: |   | ||||||||
Mailing Information | |||||||||
Address1: | 800 WESTCHESTER AVE STE N715 | ||||||||
Address2: |   | ||||||||
City: | RYE BROOK | ||||||||
State: | NY | ||||||||
PostalCode: | 105731369 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 9146075730 | ||||||||
FaxNumber: | 9144571195 | ||||||||
Practice Location | |||||||||
Address1: | 3030 WESTCHESTER AVE | ||||||||
Address2: |   | ||||||||
City: | PURCHASE | ||||||||
State: | NY | ||||||||
PostalCode: | 105772574 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 9146305973 | ||||||||
FaxNumber: |   | ||||||||
Other Information | |||||||||
ProviderEnumerationDate: | 03/26/2016 | ||||||||
LastUpdateDate: | 05/24/2021 | ||||||||
NPIDeactivationReasonCode: |   | ||||||||
NPIDeactivationDate: |   | ||||||||
NPIReactivationDate: |   | ||||||||
ProviderGenderCode: | F | ||||||||
AuthorizedOfficialLastName: |   | ||||||||
AuthorizedOfficialFirstName: |   | ||||||||
AuthorizedOfficialMiddleName: |   | ||||||||
AuthorizedOfficialTitleorPosition: |   | ||||||||
AuthorizedOfficialTelephone: |   | ||||||||
IsSoleProprietor: | Y | ||||||||
IsOrganizationSubpart: |   | ||||||||
ParentOrganizationLBN: |   | ||||||||
AuthorizedOfficialNamePrefix: |   | ||||||||
AuthorizedOfficialNameSuffix: |   | ||||||||
AuthorizedOfficialCredential: |   | ||||||||
NPICertificationDate: | 05/24/2021 |
Taxonomy Information
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 133NN1002X |   | NY | N |   | Dietary & Nutritional Service Providers | Nutritionist | Nutrition, Education | 133V00000X | 853668 | NY | N |   | Dietary & Nutritional Service Providers | Dietitian, Registered |   | 133V00000X | 005296 | NY | Y |   | Dietary & Nutritional Service Providers | Dietitian, Registered |   |
No ID Information.