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NPI Code Detail

MEDICARE: MICHELE L SEVERINI RD, CDN

MEDICARE: MICHELE L SEVERINI RD, CDN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1133V00000XRegistered Dietitian006343-1NY

General Provider Information

NPI Number : 1124283973
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHELE L SEVERINI RD, CDN
Provider Business Mailing Address
First Line : 64 THORNE ST
Second Line : APT 2
City : JERSEY CITY
State : NJ
Zip : 07307
Country : US
Telephone Number : 201-519-9454
Fax Number :
Provider Business Practice Location Address
First Line : 326 7TH ST
Second Line :
City : BROOKLYN
State : NY
Zip : 11215-3311
Country : US
Telephone Number : 718-832-7888
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/22/2008
Last Update Date : 07/22/2008

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Directions to “ MICHELE L SEVERINI RD, CDN” Practice Location

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