Individual
IRAINA SAGE ROSENTHAL-TAWIL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
210 MONTROSE AVE, BROOKLYN, NY 11206-2351
(347) 987-2218
Mailing address
1564 E 22ND ST, BROOKLYN, NY 11210-5125
(917) 880-7108
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
133VN1006X
Metabolic Nutrition Registered Dietitian
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
86115023
CDR
NY
Enumeration date
09/21/2018
Last updated
09/21/2018
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