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Individual

MS. ERICA BLACKSBURG

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MS, RD, CDN

Contact information

Practice address
14 WALL ST, SUITE 1100C, NEW YORK, NY 10005-2101
(347) 761-3198
Mailing address
14 WALL ST, SUITE 1100C, NEW YORK, NY 10005-2101
(347) 761-3198

Taxonomy

Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
849910
NY
133VN1004X
Pediatric Nutrition Registered Dietitian
849910
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
849910
NY STATE EDUCATION DEPT- CERTIFIED DIETITIAN NUTRITIONIST
NY
Enumeration date
10/17/2008
Last updated
11/30/2010
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