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Organization
TD ATHLETICS INCORPORATED
Active
Organization
TD ATHLETICS INCORPORATED
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DERRICK STRONG (OWNER)
(347) 409-7031
Entity
Organization
Contact information
Practice address
1540 VAN SICLEN AVE, BROOKLYN, NY 11239-2412
(347) 409-7031
Mailing address
1540 VAN SICLEN AVE, BROOKLYN, NY 11239-2412
Taxonomy
Speciality
Code
Description
License number
State
133VN1201X
Obesity and Weight Management Nutrition Registered Dietitian
—
—
163W00000X
Registered Nurse
—
—
171400000X
Health & Wellness Coach
Primary
—
—
2255A2300X
Athletic Trainer
—
—
Other
Enumeration date
03/19/2024
Last updated
03/22/2024
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