MEDICARE: JUDITH SABZEVARI R.D. C.D.N

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
1	133V00000X	Registered Dietitian	953764	NY

General Provider Information

NPI Number	:	1427355007
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JUDITH SABZEVARI R.D. C.D.N

Provider Business Mailing Address
First Line	:	22 MORRIS LN
Second Line	:
City	:	GREAT NECK
State	:	NY
Zip	:	11024-1707
Country	:	US
Telephone Number	:	917-828-4701
Fax Number	:

Provider Business Practice Location Address
First Line	:	22 MORRIS LN
Second Line	:
City	:	GREAT NECK
State	:	NY
Zip	:	11024-1707
Country	:	US
Telephone Number	:	917-828-4701
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/17/2011
Last Update Date	:	02/17/2011

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