Individual provider · NPI-1

Dr. Keith Thomas Ayoob, Ed.D., R.D., C.D.N.

Dietitian, Registered · Bronx, NY

NPI number1801948641
StatusActive
Last updated in NPPESNov 19, 2014

Details

NPI
1801948641
Entity type
Individual (NPI-1)
Name
Dr. Keith Thomas Ayoob
Credential
Ed.D., R.D., C.D.N.
Sex
Male
Sole proprietor
Yes
Enumeration date
Jan 18, 2007
Last updated
Nov 19, 2014

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
133V00000X Dietitian, Registered002276-1NYYes

Practice location

1165 Morris Park Ave
Room 438
Bronx, NY 10461-1915

Phone 718-430-3970 · Fax 718-823-4877

Mailing address

212 E 47th St
18f
New York, NY 10017-2128

Phone 718-430-3970 · Fax 718-823-4877

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