Organization
FULLY FUNCTIONAL NUTRITION WELLNESS PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DALIA HARUSH MS RD (OWNER)
(732) 710-7915
Entity
Organization
Contact information
Practice address
1419 E 9TH ST, BROOKLYN, NY 11230-6459
(917) 717-0146
(848) 674-0001
Mailing address
1419 E 9TH ST, BROOKLYN, NY 11230-6459
(917) 717-0146
(848) 674-0001
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
Other
Enumeration date
08/09/2024
Last updated
08/09/2024
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