Healthcare Provider Details

I. General information

NPI: 1316528672
Provider Name (Legal Business Name): IZABEL MALEK RDN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/19/2021
Last Update Date: 04/19/2021
Certification Date: 04/19/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

328 W SAINT GEORGES AVE
LINDEN NJ
07036-5638
US

IV. Provider business mailing address

286 5TH ST
SADDLE BROOK NJ
07663-6212
US

V. Phone/Fax

Practice location:
  • Phone: 908-925-2273
  • Fax: 908-925-2235
Mailing address:
  • Phone: 201-527-7870
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: